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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Medical photography is a noninvasive imaging technique that allows us to record&#44; compare&#44; follow up&#44; and monitor changes as well as to show patients lesions they are unable to see&#59; the images obtained can also be used to diagnose the condition&#44; request second opinions&#44; and for educational purposes&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> Teledermatologists diagnose patients on the basis of clinical photographs and dermoscopic images without a face-to-face consultation&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> When discussing medical photography&#44; we must approach the question from 2 perspectives&#58; that of the person taking the photograph and that of the subject&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The photographer may be the attending physician&#44; a nurse or other auxiliary staff member&#44; or a professional medical photographer&#46; Many different considerations must be taken into account in this setting&#58; ethical concerns &#40;respect for the patient&#39;s feeling and intimacy&#44; a commitment to use the images exclusively for the stated purpose&#41;&#59;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a> legal issues &#40;compliance with legislation on informed consent as well as on the secure storage and transfer of the images&#41;&#59; and technical issues related to how&#44; where&#44; and when the clinical photographs are taken&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> The first step with respect to the subject&#8212;or patient&#8212;is to obtain their informed consent&#46; The patient&#39;s response when asked to authorize photography will be influenced by how they feel about being photographed and whether what is required is an image of the whole body or a certain area&#46; Their attitude will be shaped by many factors&#44; including culture&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> religion&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a> age&#44; and mentality&#44; among others&#46; Understanding how the patient feels before the session allows the person taking the photographs to approach the task in a more respectful and ethical way&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Any study of attitudes towards medical photography will involve an evaluation of the beliefs&#44; feelings&#44; and intentions<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> of the subject in relation to such photography and&#44; ultimately&#44; how they feel about allowing someone to photograph an area of their skin for medical purposes&#46; Our attitudes are shaped by experiences&#44; our own and those of others&#44; and also by the messages communicated by significant individuals and groups about certain things or attitudinal areas&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> In the case of medical photography&#44; the information received by the general public and by patients obviously plays an important role&#44; in particular information on the methods used and the benefits obtained&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In general&#44; the photograph reveals the person&#59; it presents the subject and exposes them to their own and the other&#39;s gaze&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> Today&#44; photography is ubiquitous&#44; primarily in the hands of nonprofessionals using mobile phones&#46; As people are constantly taking photographs and being photographed&#44; the symbolism of the act has been almost emptied of its significance&#46; The democratization and trivialization of photography appear to go hand in hand&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a> Medical photography&#44; in particular&#44; conjures up instrumental meanings related to the skin in a <span class="elsevierStyleItalic">medicalized</span> body&#58; the skin becomes an area delimited by a scientific and technical viewpoint &#40;dermatology&#41; and a device &#40;the camera lens&#41; employed for precise and specific ends &#40;medical diagnosis and treatment&#41; linked to an ethic rooted in the respectability of the person taking the photograph and in the positive preventative and curative consequences of the action&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The present study was carried out to explore attitudes to medical photography among patients attending the dermatology department in Pius Hospital de Valls in Tarragona&#44; Spain&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Materials and Methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">We undertook an exploratory study of a nonrandomized group selected by accidental sampling&#44; that is&#44; a sample recruited over time and determined by real life circumstances&#44; taking into account the sociodemographic variables considered important in light of current theories about and research on the formation of the attitudes under study&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The data was collected by way of a self-administered questionnaire almost exclusively consisting of closed questions &#40;<a class="elsevierStyleCrossRef" href="#sec0060">see Annex 1 online</a>&#41;&#46; The respondents were anonymous and the questionnaire was made available in 2 languages&#58; Spanish and Catalan&#46; The questionnaire had been piloted in a preliminary study in February 2018 at the same hospital&#46; The patients who completed the questionnaire had appointments for either first or second visits at the dermatology&#44; gynecology&#44; traumatology&#44; or gastroenterology departments between March and May 2018&#46; Some of the dermatology patients were already familiar with the use of medical photography because either they or a family member had been treated by our teledermatology service&#46; This prior experience was recorded in answer to one of the questions on the questionnaire&#46; In the teledermatology consultations&#44; the photographs had been taken by the patient&#39;s family physician with verbal consent&#46; When it was deemed necessary&#44; given the patient&#39;s condition&#44; to maintain a photographic record in the department&#44; prior written informed consent had been obtained&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The questions were selected with a view to exploring the following topics&#58; the patient&#39;s beliefs about the usefulness of medical photography&#44; the circumstances in which they would agree to be photographed and by whom&#44; as well as their own and their family members&#8217; prior experience of medical photography&#46; They were also asked whether they intended to authorize the use of photography and&#44; if not&#44; to explain their motives&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Data was collected on the sociodemographic variables we considered might influence or affect the individual&#39;s attitudes to photography&#58; age&#44; sex&#44; marital status&#44; educational level&#44; occupation&#44; place of residence&#44; country of origin&#44; and religion &#40;practicing or non-practicing&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The study was approved by the ethics committee of Pius Hospital de Valls&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Organization and Data Processing</span><p id="par0055" class="elsevierStylePara elsevierViewall">The data were recorded on an Excel spreadsheet and then imported into the SPSS program &#40;IBM SPSS Statistics for Windows&#44; version 22&#46;0&#44; Armonk&#44; NY&#44; USA&#41; for statistical analysis&#46; Given the homogeneity of the raw data and the fact that all the variables were nominal&#44; it was decided to limit the organization of the results to frequencies and contingency tables&#46; Some contrast tests were performed&#44; including Chi square&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">The Sample</span><p id="par0060" class="elsevierStylePara elsevierViewall">The questionnaire was answered by 134 patients&#44; of whom 100 &#40;74&#46;6&#37;&#41; were attending the dermatology department and had previously been photographed by a dermatologist&#46; The other 34 respondents &#40;25&#46;4&#37;&#41; were patients with appointments at the gynecology&#44; traumatology&#44; or gastroenterology departments and very few of them had prior experience of medical photography&#46; The 100 dermatology patients represent 6&#46;1&#37; of the total number of patients who consulted that department during the study period&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">During that period&#44; 2&#44;270 appointments were made by the dermatology department&#46; Of these&#44; 398 were handled via teledermatology and in 233 cases &#40;10&#46;3&#37;&#41; the patient did not attend&#46; Of the remaining 1&#44;639 patients &#40;the 2&#44;270 patients less those treated via teledermatology and those who missed their appointment&#41;&#44; 100 &#40;6&#46;1&#37;&#41; submitted a completed questionnaire &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The hospital serves a reference population of approximately 64&#44;000 inhabitants in a catchment area comprising the Alt Camp and Conca de Barber&#224; regions in the Camp de Tarragona&#44; areas where 18&#37; and 24&#37;&#44; respectively&#44; of the inhabitants are aged over 65 years&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The characteristics of the 134 respondents were as follows&#58; 81 women &#40;60&#46;4&#37;&#41;&#44; 51 men &#40;38&#46;1&#37;&#41;&#44; and 2 &#40;1&#46;5&#37;&#41; individuals who did not specify their gender in answer to the question&#46; The age distribution was about half under 55 years &#40;49&#46;3&#37;&#41; and half over 55 &#40;50&#46;7&#37;&#41;&#46; Individuals over 80 years of age accounted for 9&#46;7&#37; of the sample&#46; Most of the respondents were married &#40;63&#46;4&#37;&#41; or living with a partner &#40;14&#46;2&#37;&#41;&#46; The majority reported having a primary school &#40;26&#37;&#41; or vocational level &#40;44&#37;&#41; education&#46; The largest group of occupations reported &#40;current or prior to retirement&#41; were centered around the region&#39;s factories &#40;factory workers and clerical staff&#41;&#59; the second largest was agricultural work&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Almost all the respondents were born in Spain and they were mostly Catholics&#44; although half of those who identified as Catholics declared themselves to be non-practicing&#46; All of the participants lived in Valls or adjacent areas&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Attitudes</span><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">The usefulness of medical photography in general&#46;</span> The opinion that medical photography is useful was expressed by almost all of the participants &#40;94&#46;8&#37;&#41; irrespective of age&#44; sex&#44; educational level&#44; occupation&#44; or the hospital department they were visiting &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Most of those who did not consider photography to be useful were patients of departments other than dermatology&#46; These differences were statistically significant &#40;<span class="elsevierStyleItalic">P</span> &#60; &#8722;&#46;01&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">In relation to specific uses&#46;</span> In total&#44; 86&#46;6&#37; of the respondents were of the opinion that photographs would be useful in the diagnosis of their lesions&#46; This high percentage of affirmative responses was maintained in respect of their usefulness in treatment follow-up &#40;88&#46;1&#37;&#41; and consultations with other doctors &#40;86&#46;6&#37;&#41;&#46; Fewer patients &#40;74&#46;6&#37;&#41; considered that photographs of their condition would be useful in the diagnosis of other people &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">The circumstances in which the patient was willing to authorize photography&#46;</span> The majority of patients said that they would consent to being photographed if they had malignant &#40;88&#46;8&#37;&#41; or extensive &#40;85&#46;1&#37;&#41; lesions&#46; The percentage of positive responses dropped to 78&#46;4&#37; when patients were asked about facial lesions&#46; Among women&#44; this percentage was even lower&#44; but most of those whose answer was not affirmative expressed their opinion in the form of doubts &#40;&#8220;I do not know whether I would give my consent&#8221;&#41;&#46; The percentage of respondents who said that they would consent to photography in the case of genital lesions was even lower &#40;70&#46;2&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Many of those who responded negatively to the question of consent in the case of a genital lesion expressed doubts &#40;&#8220;I do not know whether I would give my consent&#8221;&#41; rather than a flat refusal &#40;&#8220;I would not give consent&#8221;&#41;&#59; the percentages were almost equally distributed in men and women&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The question of who would take the photographs also gave rise to statistically significant differences&#58; most respondents &#40;95&#46;5&#37;&#41; expressed a willingness to be photographed by the attending doctor and a smaller proportion said they would accept another doctor &#40;64&#46;9&#37;&#41; or a nurse &#40;66&#46;4&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41;&#46; In the case of a professional photographer&#44; acceptance fell to 21&#46;6&#37; of patients&#46; In pilot interviews&#44; it was clear that patients did not consider the photographer to be an authority figure in the medical field&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The most interesting finding relating to religion was the response of 2 Muslim women with appointments at the dermatology department&#46; The women were around 30 years of age&#44; married&#44; with children&#46; While they made clear their distrust of photography in general&#44; they nonetheless recognized the diagnostic value of medical photography and stressed that it should be a female doctor who took the photographs&#46; They also insisted on the strict medical use of the images&#46; The Muslim religion prohibits representations of the divine and the human&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a></p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">The results of our study reveal that most patients have a positive attitude towards being photographed by the attending physician&#44; particularly in the case of malignant or extensive lesions&#46; We found less acceptance in the case of facial and genital images and photographs taken by non-medical personnel&#46;</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Exploring Through Photography</span><p id="par0110" class="elsevierStylePara elsevierViewall">The aim of exploratory studies is to collect initial data on the subject&#44; usually in a nonrandomized sample and using nominal and ordinal variables and mainly descriptive statistics&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The aim in this case was to explore factors that might influence patient attitudes&#44; such as their beliefs and the medical circumstances&#44; and to enquire about their intentions regarding consent&#46; Given the complex nature of the emotional aspects involved&#44; we did not address these directly but rather explored them through certain questions and the information collected during the pilot study&#46; One of the findings of that exercise was the importance of the patients&#8217; trust in the attending physician&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">This trust encompasses both the doctor&#39;s professional skills and his or her respect for the patient&#46; This respect was a key issue in one of the most significant concerns expressed by many patients about photography&#58; the strictly professional use to which the patients trust their physician will put the images obtained&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Different people have different attitudes to being photographed&#46; In general&#44; doubts about consenting to photography and refusal of consent are related to an unwillingness to be identified in the photograph and a need to defend anonymity&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Equal numbers of men and women said that they would not consent to photography in the case of a genital lesion&#44; a response that would appear to reflect the perception in our culture that the genitals engender modesty and are an intimate part of the body&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The high percentage of affirmative responses received when the question specified that the photographs would be taken by the patient&#39;s own doctor illustrates the emotional component involved&#58; trust &#40;the Spanish term <span class="elsevierStyleItalic">confianza</span> was used in the pilot interview&#41; is the feeling that most influences the decision to consent to photography&#46; By contrast&#44; a feeling of distrust about the use photographs might be put to was the motive most often cited by patients who said that they would not consent to photography at a subsequent visit&#44; that is&#44; when a specific request was made&#59; 10&#37; of the patients expressed doubts about consenting to photography in a hypothetical future consultation because they &#8220;distrusted what use such photographs might be put to&#8221;&#46; The majority &#40;70&#37;&#41; of patients who expressed such doubts had no past experience of being photographed by their dermatologist&#46; Prior experience appeared to make a difference&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusions</span><p id="par0140" class="elsevierStylePara elsevierViewall">The results of our study showed that patients have a positive attitude toward being photographed for medical purposes&#44; provided that the photographer is the attending physician&#44; and particularly in the case of malignant lesions and in non-identifiable areas of the body&#46; Our methods and findings are in line with those of Lau et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">10</span></a> Wang et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">11</span></a> Leger et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a> and Sikka&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The attitudes to medical photography of the patients in our sample may have been positively biased because they belong to a population in which teledermatology has been in use for over 6 years and in which approximately 20&#37; of patients are attended to via teledermatology using photographs&#46; Our findings are&#44; nonetheless&#44; comparable to those of other authors&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Any study of attitudes towards medical photography will involve an evaluation of the beliefs&#44; feelings&#44; and intentions of the subject in relation to such photography and&#44; ultimately&#44; how they feel about allowing someone to photograph an area of their skin for medical purposes&#46; Greater knowledge of patient attitudes provides us with insights into their fears and allow us to obtain clinical photographs in the context of a relationship based on respect for their beliefs&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of Interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Medical photography is a noninvasive technique used for diagnostic&#44; monitoring&#44; and educational purposes&#46; It is important to understand the patient&#39;s attitude to all or part of their body being photographed&#46; The objective of this study was to analyze the attitudes of patients towards medical photography at a district hospital in Tarragona&#44; Spain&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methodology</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">This exploratory study used a questionnaire to evaluate attitudes to medical photography among outpatients at Pius Hospital de Valls&#46; The questionnaire explored the patients&#8217; beliefs about the usefulness of medical photography&#44; the circumstances in which they would agree to be photographed and by whom&#44; as well as their prior experience of medical photography&#46; They were also asked whether they would authorize the use of photography and&#44; if not&#44; to explain their motives&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The questionnaire was completed by 134 patients&#46; The results showed that patients had a clearly positive attitude to being photographed for medical purposes &#40;94&#46;8&#37;&#41;&#44; treatment follow-up &#40;88&#46;1&#37;&#41;&#44; and consultation of their case with other physicians &#40;86&#46;6&#37;&#41;&#46; Acceptance was 88&#46;8&#37; if the lesion was malignant and 85&#46;1&#37; if it was extensive&#46; For facial lesions&#44; only 78&#46;4&#37; were willing to be photographed and in the case of genitals the percentage fell to 70&#46;2&#37;&#46; Most patients &#40;95&#46;5&#37;&#41; would agree to being photographed by their doctor&#46; The rate of acceptance was 66&#46;4&#37; in the case of a nurse&#44; 64&#46;9&#37; for another doctor&#44; and 21&#46;6&#37; for a professional photographer&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Our study revealed that patients have a positive attitude to being photographed for medical purposes&#44; particularly when they have a malignant lesion&#44; when the photograph is taken by their specialist&#44; and when they cannot be identified&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La fotograf&#237;a m&#233;dica es una t&#233;cnica de imagen no invasiva que se utiliza con fines diagn&#243;sticos&#44; de monitoreo y educativos&#46; Es importante conocer la actitud del paciente hacia ser fotografiado&#44; en su totalidad o en parte de su cuerpo&#46; El objetivo de este estudio es analizar la actitud de los pacientes del Pius Hospital de Valls hacia la fotograf&#237;a m&#233;dica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Metodolog&#237;a</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Este estudio exploratorio evalu&#243;&#44; a partir de un cuestionario&#44; la actitud de los pacientes que asistieron a consultas externas del Hospital Pius de Valls &#40;Espa&#241;a&#41; respecto a ser fotografiados&#46; Las preguntas estaban relacionadas con creencias en torno a la utilidad de la fotograf&#237;a m&#233;dica&#44; circunstancias bajo las cuales se autorizar&#237;a ser fotografiado y a manos de qui&#233;n&#44; experiencia con la fotograf&#237;a m&#233;dica&#44; intenci&#243;n de autorizar la fotograf&#237;a y motivos para no autorizarla&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El cuestionario fue respondido por 134 pacientes&#46; Los resultados mostraron una actitud claramente positiva hacia ser fotografiado con fines m&#233;dicos &#40;94&#44;8&#37;&#41;&#44; por seguimiento de tratamiento &#40;88&#44;1&#37;&#41; y consulta del caso con otros m&#233;dicos &#40;86&#44;6&#37;&#41;&#46; El 88&#44;8&#37; aceptar&#237;a ser fotografiado si la lesi&#243;n es maligna y el 85&#44;1&#37; si es extensa&#46; Para lesiones en el rostro&#44; solamente el 78&#44;4&#37; lo permitir&#237;a&#59; en los genitales el porcentaje es a&#250;n menor &#40;70&#44;2&#37;&#41;&#46; El 95&#44;5&#37; estar&#237;a dispuesto a dejarse fotografiar si es el mismo m&#233;dico quien la hace&#44; si es el enfermero &#40;66&#44;4&#37;&#41;&#44; otro m&#233;dico &#40;64&#44;9&#37;&#41; o un fot&#243;grafo profesional &#40;21&#44;6&#37;&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Nuestro estudio muestra una actitud positiva hacia ser fotografiado con fines m&#233;dicos&#44; siempre que el fot&#243;grafo sea el m&#233;dico tratante&#44; en lesiones malignas y en &#225;reas no identificables&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Pasquali P&#44; Hernandez M&#44; Pasquali C&#44; Fernandez K&#46; Actitudes de pacientes hacia la fotograf&#237;a m&#233;dica&#46; Estudio en poblaci&#243;n espa&#241;ola&#58; Pius Hospital de Valls &#40;Tarragona&#44; Espa&#241;a&#41;&#46; Actas Dermosifiliogr&#46; 2019&#59;110&#58;131&#8211;136&#46;</p>"
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