Man, Machine, or Both? What Should Count as an Advance in Dermoscopy.

New technologies in dermoscopy are often judged by whether they outperform clinicians on selected images. This Editorial argues that a meaningful advance should instead improve care in real clinical settings. Evidence from artificial intelligence, reflectance confocal microscopy, site-specific dermoscopy, and teledermoscopy suggests that the greatest gains occur when technology is integrated with trained clinical judgment, validated prospectively, tested across skin types and anatomical sites, and evaluated for access and patient-relevant outcomes. The central question is not whether a person or machine performs better alone, but whether the combination helps identify skin cancer earlier while avoiding unnecessary biopsies.