The Modern Era

As digital imaging matured, dermoscopy entered a new phase: watching lesions over time. Rather than making a single-visit decision about a suspicious lesion, clinicians could photograph it dermoscopically and compare it with images taken months later. Any change in structure or pattern — new dots, shifting network, evolving colour — became grounds for excision.

Systems like FotoFinder, MoleMax, and DermoGenius enabled clinics to capture, store, and systematically compare high-resolution dermoscopic images. Total body photography — capturing the entire skin surface in a single session — allowed clinicians to detect new or changing lesions that might otherwise be missed among hundreds of existing moles.

AI, smartphones, and an expanding scope

Dermoscopy has expanded far beyond melanoma detection. Modern applications encompass inflammatory dermatoses, hair and scalp disorders (trichoscopy), nail conditions (onychoscopy), infectious skin diseases, and even monitoring of treatment response.

Artificial intelligence has entered the field, with convolutional neural networks trained on large dermoscopic image datasets demonstrating accuracy comparable to expert dermatologists in experimental settings. Smartphone-compatible dermatoscopes have made the technology accessible in primary care and remote settings, and teledermatoscopy allows dermoscopic images to be shared instantly for specialist review.

In March 2024, FotoFinder Systems — a German leader in skin imaging — acquired DermLite, uniting two of the field's most influential companies and signalling that dermoscopy's future lies in the integration of hardware, software, and artificial intelligence.

Yet the fundamental principle remains unchanged from Borel's day: look closer, with better light, and you will see what the naked eye cannot. The challenge, as every generation has rediscovered, is learning what it means.