BackgroundIn clinical practice, the quality of images may vary depending on the imaging device, and the focus of the dermoscope is on the superficial layer of the lesion. Therefore, it is desirable to have a dermoscopy device that can easily focus on any lesion and clearly show the findings.ObjectivesWe conducted a clinical study to compare dermoscopic images of the same skin tumours obtained using a prototype dermoscopy camera, DZ‐D100 (DD, Casio Computer Co., Ltd.), and three existing dermoscopy imaging devices (Derma9500S®‐GR or DG, Derma Medical Inc.; DELTA 20® T or DT, HEINE Optotechnik; and DermLite Foto II Pro® or DF, DermLite LLC).MethodsDermoscopic images of 117 skin tumours from 94 patients who visited Chiba University Hospital were evaluated by two experts in terms of the focus, and the clarity and presence or absence (the primary endpoint) of seven findings (pigmented lines, shiny white lines, dots/globules, blue‐grey structures, vascular structures, milia‐like cysts and comedo‐like openings).ResultsNo significant differences in the number of cases with each of the seven findings (pigmented lines, shiny white lines, dots/globules, blue‐grey structures, vascular structures, milia‐like cysts and comedo‐like openings) among the four groups were observed. The clarity of focus was significantly better with the DD than with the other three devices (all, p < 0.05). Pigmented lines were significantly clearer with the DD than with the DF and DT (all, p < 0.05). A strong correlation was found between the focus and clarity of pigmented lines/globules, blue‐grey structures and vascular structures (all, p < 0.005).ConclusionsDD was less affected by elevated lesions and was considered to be the easiest to focus and recognize brown to black lines and dots/globules. The well‐focused captured images are also expected to be applied to diagnosis by artificial intelligence.