Sir, photography can be used to accurately record the appearance of the oral cavity as well as following specific clinical conditions over time. With observance to current legislation,1 photography can facilitate diagnosis, treatment planning and surgical procedures.1,2 It is also useful both as a medicolegal tool and treatment goal conformational record.3 Historically artists were used to produce illustrations from the descriptions of surgeons and physicians, which were highly influenced by their interpretation.

I carried out an audit to determine how often clinical photographs were present with a referral or taken at initial consultation in our department before biopsy of a suspected squamous cell or basal cell carcinoma. Photos were only present in 25% of cases, yet 85% of clinicians responded that they would have benefited from one. A diagram was present in 85% of cases, but this returns us to the same difficulty of subjectivity that was present in the late nineteenth century where the artist's illustration was influenced by the interpretation of the clinician.

In conclusion, clinical photos should become a standard part of the initial referral. Most referrers (GPs or GDPs) have access to a camera and with the implementation of e-referral systems across most UK Trusts, uncomplicated image acquisition and uploading should become standard. This is even more vital in this unprecedented time due to the risk posed by COVID-19 and will ultimately grant clinicians the ability to triage more effectively, improve patients' standard of care and prevent suspected cancer lesions being missed.