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How markup is drawn, edited, hidden, and exported in Dermi Atlas, with annotations that stay anchored to the photograph through zoom, pan, alignment, and rotation.
A finding described in a note has to be reconstructed by whoever reads the record next. A mark drawn on the photograph itself does not. Dermi Atlas provides a drawing layer over every clinical image, so the clinician who documents a site can put the mark exactly where the finding is, and the mark stays with that image for anyone who opens it later.
Annotations are stored as their own records alongside the photograph rather than painted into its pixels. The clinical original is never modified, every mark remains editable long after it was drawn, and each export decides for itself whether the markup is included. This article covers the annotation tools, how marks stay anchored to the anatomy they were placed on, editing and undo, visibility, comparison markup, injection-point pins, and the download options for annotated and original files.
The canvases in Dermi Atlas carry View and Arrange modes in their toolbar, with Annotate added for licensed sessions on the surfaces that author markup; the full body and zone review canvases add a fourth mode, Lesion, for placing lesion marks. Gestures navigate the image in View mode and reposition images in Arrange mode; the drawing tools are interactive only in Annotate mode, so a review pass can never disturb existing markup by accident. Annotate mode is left from the mode selector or with the Escape key, and re-entering it re-arms whichever tool was last used.
Annotate mode offers a Select chip followed by six drawing tools:
On wide viewports each tool occupies its own toolbar slot. On narrow viewports the slots fold into a single tool picker, so the same set is reachable on a phone or a tablet without the toolbar overflowing.
Illustrative demo with synthetic data. Learn more
A property bar sits beside the tools. While a drawing tool is armed and nothing is selected, it edits the session style applied to the next mark: a stroke color from a palette of eight presets plus a custom color picker (red is the creation default), a stroke width stepper covering one to twenty on-screen pixels, and a solid or dashed toggle. Text and pins swap the width and dash controls for a font size stepper, whose starting value is derived from the dimensions of the image being annotated so a label reads at a comparable size on a macro and on a full-face frame.
While a mark is selected, the same bar edits that record instead, and the delete control becomes active. Setting a style before drawing therefore carries the whole session, and selecting an existing mark restyles just that one.
A single image holds up to 200 annotation records, as does a single comparison group.
Marks are anchored to the image, not the screen, so a mark holds its position on the anatomy through every viewing operation:
Because the records live beside the photograph rather than inside it, none of this touches the stored image, with one exception: rotation rewrites the stored file and remaps its marks in the same operation. Markup can be restyled, moved, hidden, or deleted at any point without changing the photograph itself.
The Select tool makes existing marks interactive. Clicking a mark selects it and raises its property bar; dragging the body moves it, and the corner handles resize it. A shape can be recolored and switched between solid and dashed, a text or pin label can be resized, and the delete control removes the selection.
Illustrative demo with synthetic data. Learn more
Undo and redo sit in the canvas toolbar and answer to the platform keyboard shortcuts. Each committed change is one history step: one stroke width increment, one dash toggle, one recolor, one move, one deletion. Walking the history back restores the previous state in place and clears the current selection, so a mark is reselected before its property bar returns.
The history is scoped to the open surface and to the current session, holding up to 30 steps. Closing the viewer ends its history, while a comparison keeps its history for the length of the page session and discards it on reload; the annotations themselves are already saved and are unaffected either way.
Illustrative demo with synthetic data. Learn more
Markup is useful during documentation and distracting during a clean read of the photograph, so visibility is controlled in two places.
The Visibility control in the canvas toolbar opens a popover holding a Show Annotations toggle and an opacity slider for the annotation layer. The slider bottoms out at 20 percent rather than zero, so a faded layer stays discernible and a layer that reads as shown is never effectively invisible. Hiding the layer affects presentation only; no record is touched.
Image cards across the Image Pool and the entry workspace composite a compact rendering of each image's annotations onto the thumbnail, so markup is visible without opening anything. A toggle in the toolbar of those surfaces switches the overlays off and on, reading Hide Annotation Overlays while they are shown and Show Annotation Overlays while they are hidden. With the overlays off, any card whose image carries markup keeps a small badge reporting how many marks are hidden, so an annotated image is never mistaken for a bare one.
Illustrative demo with synthetic data. Learn more
This overlay setting is a user preference, listed as Annotation Overlays on Image Cards on the Preferences page and enabled by default. While its Remember Selection option is active, the choice is stored on the user account rather than on the browser, so it follows the clinician to whichever device they sign in from. The annotations themselves belong to the image and are shared: every user who opens that photograph sees the same markup, and only the decision to display it is personal.
A comparison carries two annotation layers at once.
The photo annotation layer holds the marks saved on the individual photographs. They appear on their own panels or layers, aligned with the images, and are read-only inside the comparison: selecting one shows a lock badge in place of the resize and rotate handles, because the mark is edited where it lives, on its own image.
The comparison annotation layer holds marks drawn in the comparison itself. These are saved with the comparison group rather than with any single photograph, and they are scoped to the surface they were drawn on, so the split view and the overlay view of the same group each keep their own set.
Inside a comparison the Visibility popover therefore lists both layers as separate rows, Comparison Annotations and Photo Annotations, each carrying its record count so hidden markup is always accounted for. The opacity slider governs both layers together.
Illustrative demo with synthetic data. Learn more
The full comparison workflow, including layouts, overlay blending, and the comparison history, is covered in Comparing Images in Split and Overlay Views.
The Pin tool is built for aesthetic treatment planning, where a site and a quantity belong together on the photograph. A click drops an anchor dot on the skin and hangs a rounded label chip below it on a short stem, so the chip never covers the point it marks. The label editor opens immediately with a default number already selected, which typing replaces, and Enter commits the pin. A label holds up to 100 characters, which is sized for a unit count or a short phrase rather than a sentence.
Pins take their color from the same palette as the other tools. Setting a color while no pin is selected changes the session color, so a run of pins can be color-coded by product or by depth; selecting an individual pin and picking a color recolors that pin alone. The font size stepper enlarges the chip while the dot stays exactly where it was placed.
Illustrative demo with synthetic data. Learn more
The result is a treatment map recorded on the photograph rather than sketched on a paper face diagram: a clinician can record planned sites and the units at each one during the consultation, and read the same map back at the next appointment.
The Download action in the Image Properties drawer branches on whether the image carries markup. On an image with no annotations the stored file downloads directly. On an annotated image the Download Image drawer opens instead, previewing the photograph and offering two options:
-annotated suffix. Very large sources, above roughly 16.7 megapixels, are uniformly downscaled.The preview updates with the selection, so the file is confirmed before it is saved, and the drawer opens on the annotated option every time. Either download is recorded in the activity log together with the option that was chosen.
Illustrative demo with synthetic data. Learn more
Composed exports treat annotations as an option rather than a fixed property of the image. A single-image export carries a Show Annotations toggle, and a comparison export offers As arranged, All annotations shown, and All annotations hidden, the same vocabulary used by PDF reports. See Exporting Images with Custom Export for the framing, theme, and branding controls that accompany it, and Generating PDF Reports for annotation handling in reports.
Dermi Atlas carries a second, deliberately temporary way to mark an image. Live Pointer is armed in View and Arrange modes, draws strokes that fade within seconds, and writes nothing to the record. It exists for the moment of explanation, when a clinician is pointing at something on a shared screen while the patient is looking at it.
The annotation tools described here are the opposite case. A mark on a photograph is committed to the image, saved with it, and carried to the other open devices within seconds, so markup drawn on a tablet in the treatment room reaches the workstation at the front desk on its own; markup scoped to a comparison is committed once its workspace closes. The two are complementary: Live Pointer for what only needs to exist during the conversation, annotations for what belongs in the record.
Annotations are available in Dermi Atlas Professional, the on-premises deployment designed for clinical use. The Dermi Atlas Cloud Demo provides access to core workflows for evaluation, though some capabilities may be restricted.
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All demonstrations, screenshots, and media on this page use synthetic data only. No real patient information is shown.
The following are synthetic and do not correspond to real patients:
Media is provided solely to illustrate platform functionality and workflows.