Marky is able to annotate biomedical texts using different annotation classes. You only need a server with php technology and one database to annotate documents with a browser. Users can enter biomedical documents to be annotated by other users and get annotations for relevant terms, such as diseases, symptoms and treatments. Whith Marky you can annote from simple documents (without any formatting) to HTML documents. So that documents can have embedded images and all power of HTML.
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Comput Methods Programs Biomed. 2015 Feb;118(2):242-51. doi: 10.1016/j.cmpb.2014.11.005. Epub 2014 Nov 25.
Marky: a tool supporting annotation consistency in multi-user and iterative document annotation projects.
Pérez-Pérez M, Glez-Peña D, Fdez-Riverola F, Lourenço A.