Artificial Intelligence and New Technologies in Melanoma Diagnosis: A Narrative Review.

Melanoma is among the most lethal forms of skin cancer, where early and accurate diagnosis significantly improves patient survival. Traditional diagnostic pathways, including clinical inspection and dermoscopy, are constrained by interobserver variability and limited access to expertise. Between 2020 and 2025, advances in artificial intelligence (AI) and medical imaging technologies have substantially redefined melanoma diagnostics. This narrative review synthesizes key developments in AI-based approaches, emphasizing the progression from convolutional neural networks to vision transformers and multimodal architectures that incorporate both clinical and imaging data. We examine the integration of AI with non-invasive imaging techniques such as reflectance confocal microscopy, high-frequency ultrasound, optical coherence tomography, and three-dimensional total body photography. The role of AI in teledermatology and mobile applications is also addressed, with a focus on expanding diagnostic accessibility. Persistent challenges include data bias, limited generalizability across diverse skin types, and a lack of prospective clinical validation. Recent regulatory frameworks, including the European Union Artificial Intelligence Act and the United States Food and Drug Administration's guidance on adaptive systems, are discussed in the context of clinical deployment. The review concludes with perspectives on explainable AI, federated learning, and strategies for equitable implementation in dermatological oncology.