An article published in the Journal of Cosmetic Dermatology aimed to review the newer diagnostic technologies in the field of dermatology and their applications, limitation and future prospectus.

The findings showed that the newer emerging diagnostic technologies in dermatology are – confocal microscopy, optical coherence tomography, digital photographic imaging, high-frequency ultrasonography and artificial intelligence (AI). Additionally, advancements relating to dermoscopes have been registered.

Machine Learning – a type of AI, marks an important advancement in imaging modalities. Integrating AI into imaging technologies confers higher precision and refines diagnosis.

Digital Photographic Imaging – the advent of new generation digital cameras has improved the assessment of prognoses of dermatological therapies. Other technologies that have been integrated into dermatological imaging to improve diagnoses and treatment planning are – polarized light, total body digital photography (TBDP) and 3-dimensional (3D) TBDP. 

Dermoscopy – also known as chemiluminescence microscope, aids in differentiating lesions, for instance – a melanoma from a melanocytic lesion, and for the clinical diagnoses of inflammatory dermatoses. New generation of dermoscopes also has in-built photography with software that captures, saves and analyzes images. Tele-dermoscopy enables sharing of digitalized dermoscopic images for the diagnosis, treatment planning, knowledge transfer and follow-up. This improves the reliability of telediagnosis and better delivery of therapies in remote areas.

Confocal Microscopy – utilizes 830 nm laser to provide cellular detail of the skin and cutaneous structures. This technique is useful for differentiating between skin cancer types.

Optical Coherence Tomography (OCT) – utilizes back-scattered light to generate images and aids in tumor diagnosis by enabling visualization of various layers of the skin. Multiphoton tomography is another emerging diagnostic modality in this arena.

High-frequency Ultrasonography – uses sound waves of varying impedance to image cutaneous structures and provides a greater depth of visualization than OCT. Meanwhile, color Doppler detects blood flow. These modalities are used to analyze the tumor depth, tumor recurrence and the efficacy of therapeutic interventions.

Multispectral Optoacoustic Tomography – applies pulsed infrared light (680-980 nm) to the skin that renders thermo-elastic expansion and generates ultrasound waves. This technique can image depths up to 1 cm and create 3D images for presurgical mapping.

Fluorescence Imaging – employs the fluorescent properties of cells and tissues that absorb ultraviolet/visible light radiation. This mode is used for diagnosing skin cancer, aging and inflammatory dermatoses.

Multispectral and Hyperspectral Imaging – are employed for tissue imaging to determine tissue oxygenation in lesions like ulcers.

Multiphoton Tomography – uses femtosecond lasers noninvasively and allows for high-resolution and 3D microscopy.

Spectroscopy – is used in clinical pharmacology and toxicology. It is used for investigating suspicious melanocytic lesions, skin cancers and pigmented nevi. 

Newer emerging modalities are being increasingly accessed by physicians and surgeons and are likely to be greatly influenced by AI. These are useful for gaining precise diagnosis, treatment planning, minimizing invasive procedures, as well as predicting therapeutic outcomes. 

Source: Jartarkar SR, Patil A, Wollina U, et al. New diagnostic and imaging technologies in dermatology. J Cosmet Dermatol. 2021;20(12):3782-7.