Teledermatology has become a widely accepted communication method in daily clinical practice, enabling remote care while showing strong agreement with in-person visits. Poor image quality remains an unsolved problem in teledermatology and is a major concern to practitioners, as bad-quality images reduce the usefulness of the remote consultation process. However, research on Image Quality Assessment (IQA) in dermatology is sparse, and does not leverage the latest advances in non-dermatology IQA, such as using larger image databases with ratings from large groups of human observers. In this work, we propose cross-domain training of IQA models, combining dermatology and non-dermatology IQA datasets. For this purpose, we created a novel dermatology IQA database, Legit.Health-DIQA-Artificial, using dermatology images from several sources and having them annotated by a group of human observers. We demonstrate that cross-domain training yields optimal performance across domains and overcomes one of the biggest limitations in dermatology IQA, which is the small scale of data, and leads to models trained on a larger pool of image distortions, resulting in a better management of image qualit
The adoption of artificial intelligence in dermatology promises democratized access to healthcare, but model reliability depends on the quality and comprehensiveness of the data fueling these models. Despite rapid growth in publicly available dermatology images, the field lacks quantitative key performance indicators to measure whether new datasets expand clinical coverage or merely replicate what is already known. Here we present SkinMap, a multi-modal framework for the first comprehensive audit of the field's entire data basis. We unify the publicly available dermatology datasets into a single, queryable semantic atlas comprising more than 1.1 million images of skin conditions and quantify (i) informational novelty over time, (ii) dataset redundancy, and (iii) representation gaps across demographics and diagnoses. Despite exponential growth in dataset sizes, informational novelty across time has somewhat plateaued: Some clusters, such as common neoplasms on fair skin, are densely populated, while underrepresented skin types and many rare diseases remain unaddressed. We further identify structural gaps in coverage: Darker skin tones (Fitzpatrick V-VI) constitute only 5.8% of image
Foundation models have transformed medical image analysis by providing robust feature representations that reduce the need for large-scale task-specific training. However, current benchmarks in dermatology often reduce the complex diagnostic taxonomy to flat, binary classification tasks, such as distinguishing melanoma from benign nevi. This oversimplification obscures a model's ability to perform fine-grained differential diagnoses, which is critical for clinical workflow integration. This study evaluates the utility of embeddings derived from ten foundation models, spanning general computer vision, general medical imaging, and dermatology-specific domains, for hierarchical skin lesion classification. Using the DERM12345 dataset, which comprises 40 lesion subclasses, we calculated frozen embeddings and trained lightweight adapter models using a five-fold cross-validation. We introduce a hierarchical evaluation framework that assesses performance across four levels of clinical granularity: 40 Subclasses, 15 Main Classes, 2 and 4 Superclasses, and Binary Malignancy. Our results reveal a "granularity gap" in model capabilities: MedImageInsights achieved the strongest overall performa
With the widespread application of artificial intelligence (AI), particularly deep learning (DL) and vision large language models (VLLMs), in skin disease diagnosis, the need for interpretability becomes crucial. However, existing dermatology datasets are limited in their inclusion of concept-level meta-labels, and none offer rich medical descriptions in natural language. This deficiency impedes the advancement of LLM-based methods in dermatologic diagnosis. To address this gap and provide a meticulously annotated dermatology dataset with comprehensive natural language descriptions, we introduce \textbf{SkinCaRe}, a comprehensive multimodal resource that unifies \textit{SkinCAP} and \textit{SkinCoT}. \textbf{SkinCAP} comprises 4,000 images sourced from the Fitzpatrick 17k skin disease dataset and the Diverse Dermatology Images dataset, annotated by board-certified dermatologists to provide extensive medical descriptions and captions. In addition, we introduce \textbf{SkinCoT}, a curated dataset pairing 3,041 dermatologic images with clinician-verified, hierarchical chain-of-thought (CoT) diagnoses. Each diagnostic narrative is rigorously evaluated against six quality criteria and i
Medical vision-language models (VLMs) have shown promise as clinical assistants across various medical fields. However, specialized dermatology VLM capable of delivering professional and detailed diagnostic analysis remains underdeveloped, primarily due to less specialized text descriptions in current dermatology multimodal datasets. To address this issue, we propose MM-Skin, the first large-scale multimodal dermatology dataset that encompasses 3 imaging modalities, including clinical, dermoscopic, and pathological and nearly 10k high-quality image-text pairs collected from professional textbooks. In addition, we generate over 27k diverse, instruction-following vision question answering (VQA) samples (9 times the size of current largest dermatology VQA dataset). Leveraging public datasets and MM-Skin, we developed SkinVL, a dermatology-specific VLM designed for precise and nuanced skin disease interpretation. Comprehensive benchmark evaluations of SkinVL on VQA, supervised fine-tuning (SFT) and zero-shot classification tasks across 8 datasets, reveal its exceptional performance for skin diseases in comparison to both general and medical VLM models. The introduction of MM-Skin and S
The emergence of vision-language models has transformed medical AI, enabling unprecedented advances in diagnostic capability and clinical applications. However, progress in dermatology has lagged behind other medical domains due to the lack of standard image-text pairs. Existing dermatological datasets are limited in both scale and depth, offering only single-label annotations across a narrow range of diseases instead of rich textual descriptions, and lacking the crucial clinical context needed for real-world applications. To address these limitations, we present Derm1M, the first large-scale vision-language dataset for dermatology, comprising 1,029,761 image-text pairs. Built from diverse educational resources and structured around a standard ontology collaboratively developed by experts, Derm1M provides comprehensive coverage for over 390 skin conditions across four hierarchical levels and 130 clinical concepts with rich contextual information such as medical history, symptoms, and skin tone. To demonstrate Derm1M potential in advancing both AI research and clinical application, we pretrained a series of CLIP-like models, collectively called DermLIP, on this dataset. The DermLIP
A historical record of a seismic tsunami is identified in the Irish annals for October 720 (all dates herein CE). It is contained in the earliest stratum of the annals, which survives in the form of a handful of iterated scribal copies of the foundational text of the tradition. This was compiled by the contemporary observation of noteworthy events for the years c. 563-740 at the monastery of Iona in the Scottish Hebrides. The 720 event is close outside the 2$σ$ radiocarbon terminus ante quem date ranges for tsunami deposits identified at Dury Voe (530-660) and Basta Voe (430-650) in the Shetland Isles, and is identified as a candidate progenitor. The possibility of the existence of associated tsunami deposits in Scotland or on the north coast of Ireland is highlighted.
A major barrier to developing vision large language models (LLMs) in dermatology is the lack of large image--text pairs dataset. We introduce DermaSynth, a dataset comprising of 92,020 synthetic image--text pairs curated from 45,205 images (13,568 clinical and 35,561 dermatoscopic) for dermatology-related clinical tasks. Leveraging state-of-the-art LLMs, using Gemini 2.0, we used clinically related prompts and self-instruct method to generate diverse and rich synthetic texts. Metadata of the datasets were incorporated into the input prompts by targeting to reduce potential hallucinations. The resulting dataset builds upon open access dermatological image repositories (DERM12345, BCN20000, PAD-UFES-20, SCIN, and HIBA) that have permissive CC-BY-4.0 licenses. We also fine-tuned a preliminary Llama-3.2-11B-Vision-Instruct model, DermatoLlama 1.0, on 5,000 samples. We anticipate this dataset to support and accelerate AI research in dermatology. Data and code underlying this work are accessible at https://github.com/abdurrahimyilmaz/DermaSynth.
While artificial intelligence (AI) holds promise for supporting healthcare providers and improving the accuracy of medical diagnoses, a lack of transparency in the composition of datasets exposes AI models to the possibility of unintentional and avoidable mistakes. In particular, public and private image datasets of dermatological conditions rarely include information on skin color. As a start towards increasing transparency, AI researchers have appropriated the use of the Fitzpatrick skin type (FST) from a measure of patient photosensitivity to a measure for estimating skin tone in algorithmic audits of computer vision applications including facial recognition and dermatology diagnosis. In order to understand the variability of estimated FST annotations on images, we compare several FST annotation methods on a diverse set of 460 images of skin conditions from both textbooks and online dermatology atlases. We find the inter-rater reliability between three board-certified dermatologists is comparable to the inter-rater reliability between the board-certified dermatologists and two crowdsourcing methods. In contrast, we find that the Individual Typology Angle converted to FST (ITA-FS
In recent years, deep learning (DL) has shown great potential in the field of dermatological image analysis. However, existing datasets in this domain have significant limitations, including a small number of image samples, limited disease conditions, insufficient annotations, and non-standardized image acquisitions. To address these shortcomings, we propose a novel framework called DermSynth3D. DermSynth3D blends skin disease patterns onto 3D textured meshes of human subjects using a differentiable renderer and generates 2D images from various camera viewpoints under chosen lighting conditions in diverse background scenes. Our method adheres to top-down rules that constrain the blending and rendering process to create 2D images with skin conditions that mimic in-the-wild acquisitions, ensuring more meaningful results. The framework generates photo-realistic 2D dermoscopy images and the corresponding dense annotations for semantic segmentation of the skin, skin conditions, body parts, bounding boxes around lesions, depth maps, and other 3D scene parameters, such as camera position and lighting conditions. DermSynth3D allows for the creation of custom datasets for various dermatolog
Racial bias in medicine, such as in dermatology, presents significant ethical and clinical challenges. This is likely to happen because there is a significant underrepresentation of darker skin tones in training datasets for machine learning models. While efforts to address bias in dermatology have focused on improving dataset diversity and mitigating disparities in discriminative models, the impact of racial bias on generative models remains underexplored. Generative models, such as Variational Autoencoders (VAEs), are increasingly used in healthcare applications, yet their fairness across diverse skin tones is currently not well understood. In this study, we evaluate the fairness of generative models in clinical dermatology with respect to racial bias. For this purpose, we first train a VAE with a perceptual loss to generate and reconstruct high-quality skin images across different skin tones. We utilize the Fitzpatrick17k dataset to examine how racial bias influences the representation and performance of these models. Our findings indicate that VAE performance is, as expected, influenced by representation, i.e. increased skin tone representation comes with increased performance
Vision-language models (VLMs) are increasingly important in medical applications; however, their evaluation in dermatology remains limited by datasets that focus primarily on image-level classification tasks such as lesion recognition. While valuable for recognition, such datasets cannot assess the full visual understanding, language grounding, and clinical reasoning capabilities of multimodal models. Visual question answering (VQA) benchmarks are required to evaluate how models interpret dermatological images, reason over fine-grained morphology, and generate clinically meaningful descriptions. We introduce DermaBench, a clinician-annotated dermatology VQA benchmark built on the Diverse Dermatology Images (DDI) dataset. DermaBench comprises 656 clinical images from 570 unique patients spanning Fitzpatrick skin types I-VI. Using a hierarchical annotation schema with 22 main questions (single-choice, multi-choice, and open-ended), expert dermatologists annotated each image for diagnosis, anatomic site, lesion morphology, distribution, surface features, color, and image quality, together with open-ended narrative descriptions and summaries, yielding approximately 14.474 VQA-style ann
Phosphorus (P) is considered to be one of the key elements for life, making it an important element to look for in the abundance analysis of spectra of stellar systems. Yet, there exists only a handful of spectroscopic studies to estimate the P abundances and investigate its trend across a range of metallicities. We have observed full HK band spectra at a spectral resolving power of R=45,000 with IGRINS instrument. Abundances are determined using SME in combination with 1D MARCS stellar atmosphere models. The investigated sample of stars have reliable stellar parameters estimated using optical FIES spectra (GILD; Jönsson et al. in prep.). In order to determine the P abundances from the 16482.92 Angstrom P line, we take special care of the CO($ν=7-4$) blend. We determine the C, N, O abundances from atomic carbon and a range of non-blended molecular lines (CO, CN, OH) which are aplenty in the H band region of K giant stars, assuring an appropriate modelling of the blending CO($ν=7-4$) line. We present [P/Fe] vs [Fe/H] trend for 38 K giant stars in the metallicity range of -1.2 dex $<$ [Fe/H] $<$ 0.4 dex. We find that our trend matches well with the compiled literature sample of
Deep learning models for skin disease classification require large, diverse, and well-annotated datasets. However, such resources are often limited due to privacy concerns, high annotation costs, and insufficient demographic representation. While text-to-image diffusion probabilistic models (T2I-DPMs) offer promise for medical data synthesis, their use in dermatology remains underexplored, largely due to the scarcity of rich textual descriptions in existing skin image datasets. In this work, we introduce LesionGen, a clinically informed T2I-DPM framework for dermatology image synthesis. Unlike prior methods that rely on simplistic disease labels, LesionGen is trained on structured, concept-rich dermatological captions derived from expert annotations and pseudo-generated, concept-guided reports. By fine-tuning a pretrained diffusion model on these high-quality image-caption pairs, we enable the generation of realistic and diverse skin lesion images conditioned on meaningful dermatological descriptions. Our results demonstrate that models trained solely on our synthetic dataset achieve classification accuracy comparable to those trained on real images, with notable gains in worst-cas
Skin diseases impose a substantial burden on global healthcare systems, driven by their high prevalence (affecting up to 70% of the population), complex diagnostic processes, and a critical shortage of dermatologists in resource-limited areas. While artificial intelligence(AI) tools have demonstrated promise in dermatological image analysis, current models face limitations-they often rely on large, manually labeled datasets and are built for narrow, specific tasks, making them less effective in real-world settings. To tackle these limitations, we present DermNIO, a versatile foundation model for dermatology. Trained on a curated dataset of 432,776 images from three sources (public repositories, web-sourced images, and proprietary collections), DermNIO incorporates a novel hybrid pretraining framework that augments the self-supervised learning paradigm through semi-supervised learning and knowledge-guided prototype initialization. This integrated method not only deepens the understanding of complex dermatological conditions, but also substantially enhances the generalization capability across various clinical tasks. Evaluated across 20 datasets, DermNIO consistently outperforms stat
Artificial intelligence is poised to augment dermatological care by enabling scalable image-based diagnostics. Yet, the development of robust and equitable models remains hindered by datasets that fail to capture the clinical and demographic complexity of real-world practice. This complexity stems from region-specific disease distributions, wide variation in skin tones, and the underrepresentation of outpatient scenarios from non-Western populations. We introduce DermaCon-IN, a prospectively curated dermatology dataset comprising 5,450 clinical images from 3,002 patients across outpatient clinics in South India. Each image is annotated by board-certified dermatologists with 245 distinct diagnoses, structured under a hierarchical, aetiology-based taxonomy adapted from Rook's classification. The dataset captures a wide spectrum of dermatologic conditions and tonal variation commonly seen in Indian outpatient care. We benchmark a range of architectures, including convolutional models (ResNet, DenseNet, EfficientNet), transformer-based models (ViT, MaxViT, Swin), and Concept Bottleneck Models to establish baseline performance and explore how anatomical and concept-level cues may be int
The rapid growth of dermatological imaging and mobile diagnostic tools calls for systems that not only demonstrate empirical performance but also provide strong theoretical guarantees. Deep learning models have shown high predictive accuracy; however, they are often criticized for lacking well, calibrated uncertainty estimates without which these models are hardly deployable in a clinical setting. To this end, we present the Conformal Bayesian Dermatological Classifier (CBDC), a well, founded framework that combines Statistical Learning Theory, Topological Data Analysis (TDA), and Bayesian Conformal Inference. CBDC offers distribution, dependent generalization bounds that reflect dermatological variability, proves a topological stability theorem that guarantees the invariance of convolutional neural network embeddings under photometric and morphological perturbations and provides finite conformal coverage guarantees for trustworthy uncertainty quantification. Through exhaustive experiments on the HAM10000, PH2, and ISIC 2020 datasets, we show that CBDC not only attains classification accuracy but also generates calibrated predictions that are interpretable from a clinical perspecti
Recent advances in dermatological image analysis have been driven by large-scale annotated datasets; however, most existing benchmarks focus on dermatoscopic images and lack patient-authored queries and clinical context, limiting their applicability to patient-centered care. To address this gap, we introduce DermaVQA-DAS, an extension of the DermaVQA dataset that supports two complementary tasks: closed-ended question answering (QA) and dermatological lesion segmentation. Central to this work is the Dermatology Assessment Schema (DAS), a novel expert-developed framework that systematically captures clinically meaningful dermatological features in a structured and standardized form. DAS comprises 36 high-level and 27 fine-grained assessment questions, with multiple-choice options in English and Chinese. Leveraging DAS, we provide expert-annotated datasets for both closed QA and segmentation and benchmark state-of-the-art multimodal models. For segmentation, we evaluate multiple prompting strategies and show that prompt design impacts performance: the default prompt achieves the best results under Mean-of-Max and Mean-of-Mean evaluation aggregation schemes, while an augmented prompt
Our work introduces the DermETAS-SNA LLM Assistant that integrates Dermatology-focused Evolutionary Transformer Architecture Search with StackNet Augmented LLM. The assistant dynamically learns skin-disease classifiers and provides medically informed descriptions to facilitate clinician-patient interpretation. Contributions include: (1) Developed an ETAS framework on the SKINCON dataset to optimize a Vision Transformer (ViT) tailored for dermatological feature representation and then fine-tuned binary classifiers for each of the 23 skin disease categories in the DermNet dataset to enhance classification performance; (2) Designed a StackNet architecture that integrates multiple fine-tuned binary ViT classifiers to enhance predictive robustness and mitigate class imbalance issues; (3) Implemented a RAG pipeline, termed Diagnostic Explanation and Retrieval Model for Dermatology, which harnesses the capabilities of the Google Gemini 2.5 Pro LLM architecture to generate personalized, contextually informed diagnostic descriptions and explanations for patients, leveraging a repository of verified dermatological materials; (4) Performed extensive experimental evaluations on 23 skin disease
The growing demand for accurate and equitable AI models in digital dermatology faces a significant challenge: the lack of diverse, high-quality labeled data. In this work, we investigate the potential of domain-specific foundation models for dermatology in addressing this challenge. We utilize self-supervised learning (SSL) techniques to pre-train models on a dataset of over 240,000 dermatological images from public and private collections. Our study considers several SSL methods and compares the resulting foundation models against domain-agnostic models like those pre-trained on ImageNet and state-of-the-art models such as MONET across 12 downstream tasks. Unlike previous research, we emphasize the development of smaller models that are more suitable for resource-limited clinical settings, facilitating easier adaptation to a broad range of use cases. Results show that models pre-trained in this work not only outperform general-purpose models but also approach the performance of models 50 times larger on clinically relevant diagnostic tasks. To promote further research in this direction, we publicly release both the training code and the foundation models, which can benefit clinici