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Journal of the American Academy of Dermatology
Volume 80, n° 6
pages 1564-1584 (juin 2019)
Doi : 10.1016/j.jaad.2018.08.035
accepted : 18 August 2018
Original Articles

Developing an international standard for the classification of surface anatomic location for use in clinical practice and epidemiologic research

Katherine A. Kenneweg, MD, MSBS a, Allan C. Halpern, MD, MSc b, Robert J.G. Chalmers, FRCP c, d, H. Peter Soyer, MD e, Michael Weichenthal, MD f, Matthew A. Molenda, MD, MBA g,
a Department of Dermatology, University of Minnesota, Minneapolis, Minnesota 
b Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York 
c University of Manchester, Manchester, United Kingdom 
d Medical and Scientific Advisory Committee, International Classification of Diseases Revision Project, World Health Organization, Geneva, Switzerland 
e Dermatology Research Centre, The University of Queensland, The University of Queensland Diamantina Institute, Brisbane, Australia 
f Department of Dermatology, Venereology and Allergology, Christian-Albrechts-University of Kiel, Kiel, Germany 
g Bravia Dermatology, Toledo, Ohio 

Correspondence to: Matthew A. Molenda, MD, FAAD, MBA, Bravia Dermatology, 2000 Regency Ct, Ste 201, Toledo, OH 43623.Bravia Dermatology2000 Regency Ct, Ste 201ToledoOH43623

There is currently no universally adopted terminology for defining human surface anatomic location. The lack of precision, accuracy, and reliability of terms used by health care providers, in particular dermatologic surgeons, is unsatisfactory both for epidemiologic research and for high-quality patient care.


We sought to create a clinically relevant yet concise surface anatomy terminology for international use including the International Classification of Diseases and to map it to existing disparate terminologies.


Widely used surface anatomy terminology data sets and diagrams were reviewed. A Delphi consensus convened to create a novel surface anatomy terminology. The new terminology was hierarchically mapped to Systematized Nomenclature of Medicine terms and New York University numbers and physically mapped to 2-dimensional anatomic diagrams for clarity and reproducibility.


The final terminology data set contains 519 discrete terms arranged in a 9-level hierarchy and has been adopted by the World Health Organization for the International Classification of Diseases, 11th revision .


Specification of most locations requires linking to laterality qualifiers. Fine granularity for larger sites may require the use of additional qualifiers.


Consistent use of precise and accurate surface anatomy terms is crucial to the practice of dermatology, particularly procedural dermatology. The proposed terminology is designed to form the basis for evolution of a universally adoptable terminology set to improve patient care, interprovider communication, and epidemiologic tracking.

The full text of this article is available in PDF format.
Graphical abstract

The full text of this article is available in PDF format.

Key words : anatomical nomenclature, dermatology, surface anatomy, surface topography

 Supported by a P30 Cancer Center Support Grant (P30 CA008748).
 Dr Molenda is the developer and owner of Dr Soyer is a shareholder and consultant for e-derm GmbH, a shareholder and consultant for MoleMap by Dermatologists Pty Ltd., and a consultant for Canfield Scientific. Dr Halpern is an advisory board member for Syneos Health. The other authors have no conflicts of interest to disclose.

© 2019  Published by Elsevier Masson SAS.
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