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Digital imaging, whereby information obtained with a video camera is digitized and stored in a computer, is a new way that dermatologists can keep records of their patients' skin diseases. A review of digital imaging technology and its applications to dermatology is presented. The stored image can be viewed on a computer monitor when desired, and images obtained at different times can be compared to determine, for example, whether a lesion has grown, or whether treatment is effective. The necessary equipment is described. A study of 10 patients with different skin disorders allowed the versatility of the system to be demonstrated. In general, the images had good resolution and true colors, and multiple skin lesions could be processed with ease. Affected areas were measured and outlined. The system also allowed information regarding the patient and treatment protocol to be stored with the image. Several advantages of digital imaging over photography are cited. These include: lower cost per frame; dependability; ease of editing or modifying the information; and quick access to one record among thousands. Resolution of the image, an important aspect, is still poorer with the easily available imaging technology than with conventional film. Excellent resolution can be obtained with very expensive equipment, such as that currently used for high-budget Hollywood films; this will probably become more accessible when high-resolution television becomes a consumer item. Other drawbacks include the large amount of space needed for the digital imaging set-up and the need for training the operator. Overall, the method holds much promise for the clinical dermatologist. (Consumer Summary produced by Reliance Medical Information, Inc.)

• BACKGROUND AND DESIGN.— A prospective 5-year population-based incidence study was conducted on the island of Kauai, Hawaii, from 1983 through 1987 to investigate the frequency of keratoacanthoma in white residents. RESULTS.— A total of 53 residents, 36 men and 17 women, were identified with an initial episode of keratoacanthoma during the 5-year study. The average annual incidence rate per 100 000 Kauai residents, standardized to the US white population, was 144 for men and 73 for women, with a combined rate of 104. The average patient age was 63.5 years. The limbs, particularly the hands and arms, were the most common anatomic site, with the trunk second. Only one patient developed a new subsequent keratoacanthoma, and no recurrent lesions were observed. Three patients had two keratoacanthomas when they first presented, and 13 patients had concurrent skin cancer. Sixty percent (32) of our patients developed skin cancer at one time or another. CONCLUSIONS.— We report the first population-based keratoacanthoma incidence rates documented in the United States, which are almost equal to those of squamous cell carcinoma. Keratoacanthoma also shares many common epidemiological features with squamous cell carcinoma, such as increasing incidence in progressively older age groups.(Arch Dermatol. 1993;129:317-319)