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Background Dermatology is one of many specialities competing for space in the undergraduate curriculum, and recent review reveals that in some medical schools only a minority of students receives direct teaching from dermatologists. Enlargement of medical schools and dispersion of students over multiple sites further increase the strain on teaching resources. Objectives To develop and obtain 'proof of concept' for a technology to teach skin examination, using an approach grounded in modern theories of learning. Methods The requirements for an e-learning technology were identified through literature review and qualitative analysis of stakeholders' requirements with respondent and expert validation. A method of teaching skin examination was developed by applying Anderson's theory of skills acquisition. It was prototyped first on paper, then electronically, and its usability as an instructional tool was evaluated. Results The project delivered, firstly, a specification for skin examination derived from published evidence, textbook content, and staff and student consensus; and secondly, a very useable technology to help students learn skin examination (http://www.skillsbase.man.ac.uk). A validation task was completed in 20 min without significant usability problems, and evaluators found it simple, intuitive, interactive and enjoyable to use. Students saw it as an adjunct that would help them build confidence and revise for examinations. Nonstakeholder teachers expressed concern about the apparent simplicity of its contents and felt that it should only be used in association with traditional teaching methods. Conclusions Students, educationalists and teachers were able to codesign a useable skin examination package, which merits evaluation of efficacy. In view of the logistic difficulties of teaching dermatology to the growing student population, the technology may be a useful adjunct to traditional teaching methods. Our approach may inform further developments in educational technology in dermatology. [ABSTRACT FROM AUTHOR]