在遠距醫療需求越來越強烈下，針對病患端所在之環境光源對所拍攝影像的色彩偏移有很大影響，尤其遠距皮膚科診察時更需要原始色彩影像，以便提供醫生足以辨識之皮膚病灶影像。本研究主要以標準光源 D50(色溫 5000K)為標準日光，另以兩只高演色性 LED (CRI≧80)色溫各為 4400K、5500K 實測與 D50 的色差值。實驗方法取數個顏色樣本在上述三種不同光源下，透過三種拍照設備產生不同的色彩感覺。評估方式以拍攝照片透過 Photoshop 檢視影像中數個顏色樣本的 RGB 顏色數值，經 RGB 顏色空間轉換成XYZ 顏色空間，再轉換成 Lab 顏色空間即可換算成大家熟知的△E??及△E00色差數值，其中△E00為最新 CIE 規範更符合人眼判別用以評量色調之色彩差別，作為 B2C 遠距皮膚科診察光源之建議。另傳送影像診察時，所拍攝影像中並無參考體辨識顏色是否正確，本研究實驗以診察時須出示的健保卡上全民健康保險標誌內小綠人為基準，醫師即可直覺透過小綠人色彩差異多寡，評量影像色彩品質是否符合其認知，建議患者重拍或調整光源，提升遠距皮膚科診斷正確率，建立良好醫病溝通基準。實驗結果顯示，色溫差異直接影響顏色色彩空間位置，各樣本顏色的反射能量不同其色差影響亦不同，當距離標準光源 D50 色溫5000K±500K 時，其顏色色差平均值約落於△E00=6~11，△E00≦13 可視為同一色調。本研究成果可作為 B2C 遠距皮膚科診察參考。

With increasing demand for telemedicine, the ambient light source on patient side has a great impact on the color shift of captured image, especially in the case of teledermatology, the original color image is required to provide doctors enough information to identify skin lesions. In this study, the standard light source D50 (color temperature 5000K) is used as the standard sunlight, and two high color rendering LEDs (CRI≧80) are selected with color temperatures of 4400K and 5500K respectively. Experimental method is to take several color samples under above-mentioned three different light sources, and produces different color sensations through three kinds of photographing devices. The evaluation method is to take a photo and inspect the RGB color values of various color image samples through Photoshop. After converting the RGB color space into XYZ color space, and then converting again into the Lab color space, so image color space can be converted into well-known △E?? and △E00 color difference value for evaluation. The △E00 definition in the latest CIE standard is more consistent with human eye’s perception while judging the hue differences, it is recommended as a light source for B2C remote dermatology diagnosis. In addition, experiment is based on the little green men logo on health insurance card that must be presented at the time of diagnosis. Doctors can intuitively see through the little green men logo and judge whether the color quality of obtained image is with their perception, otherwise the patient is advised to retake or adjust the light source if necessary, to improve the accuracy of remote dermatology diagnosis and establish a good communication benchmark for doctors and patients. Experimental results show that the color temperature difference directly affects the color space position, and the reflected energy of each sample is also different. When the distance from the standard light source D50 color temperature is 5000K±500K, the color difference value is about △E00=6~11. Situation of △E00≦13 can be regarded as the same hue. Results of this study can be used as a reference for B2C teledermatology.

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