Skin imaging / total body photography and dermoscopy

Dermoscopy (also called dermatoscopy or epiluminescence microscopy) uses a handheld lens at roughly 10× magnification with polarised or immersion light to visualise sub-surface pigment patterns and vascular structures invisible to the naked eye. A meta-analysis of clinical-setting studies showed dermoscopy improves the diagnostic odds ratio for melanoma by approximately 9- to 15-fold compared with naked-eye examination. Total body photography (TBP) creates a standardised baseline of all pigmented lesions and, combined with sequential digital dermoscopy, supports surveillance of high-risk patients (more than 50 atypical nevi, familial atypical multiple mole melanoma syndrome, prior melanoma). AI-augmented systems (FotoFinder, SkinVision, MoleScope) and convolutional neural networks have shown dermatologist-level sensitivity in research settings but their performance in routine practice is variable. The modality is non-invasive and radiation-free; limitations include operator training, lower accuracy in amelanotic or nail/acral lesions, and the unresolved trade-off between earlier diagnosis and over-biopsy.