Machine learning (ML) is pervasively deployed.

However, there are only a few datasets that include concept-level meta-labels and most of these meta-labels are relevant for natural images that do not require domain expertise. Previous densely annotated datasets in medicine focused on meta-labels that are relevant to a single disease such as osteoarthritis or melanoma. In dermatology, skin disease is described using an established clinical lexicon that allow clinicians to describe physical exam findings to one another. To provide the first medical dataset densely annotated by domain experts to provide annotations useful across multiple disease processes, we developed SkinCon: a skin disease dataset densely annotated by dermatologists. SkinCon includes 3230 images from the Fitzpatrick 17k skin disease dataset densely annotated with 48 clinical concepts, 22 of which have at least 50 images representing the concept.

AI-based dermatology adoption remains limited by biased datasets, variable image quality, and limited validation. We introduce DermAI, a lightweight, smartphone-based application that enables real-time capture, annotation, and classification of skin lesions during routine consultations. Unlike prior dermoscopy-focused tools, DermAI performs on-device quality checks, and local model adaptation. The DermAI clinical dataset, encompasses a wide range of skin tones, ethinicity and source devices. In preliminary experiments, models trained on public datasets failed to generalize to our samples, while fine-tuning with local data improved performance. These results highlight the importance of standardized, diverse data collection aligned with healthcare needs and oriented to machine learning development.

These same concepts were also used to label 656 skin disease images from the Diverse Dermatology Images dataset, providing an additional external dataset with diverse skin tone representations.

Machine learning (ML) is pervasively deployed.

Abstract--Skin diseases are among the most prevalent health concerns worldwide, yet conventional diagnostic methods are often costly, complex, and unavailable in low-resource settings. Automated classification using deep learning has emerged as a promising alternative, but existing studies are mostly limited to dermoscopic datasets and a narrow range of disease classes. In this work, we curate a large dataset of over 50 skin disease categories captured with mobile devices, making it more representative of real-world conditions. We evaluate multiple convo-lutional neural networks and Transformer-based architectures, demonstrating that Transformer models, particularly the Swin Transformer, achieve superior performance by effectively capturing global contextual features. T o enhance interpretability, we incorporate Gradient-weighted Class Activation Mapping (Grad-CAM), which highlights clinically relevant regions and provides transparency in model predictions. Our results underscore the potential of Transformer-based approaches for mobile-acquired skin lesion classification, paving the way toward accessible AIassisted dermatological screening and early diagnosis in resource-limited environments. Skin diseases are among the most common health problems worldwide, impacting millions of individuals across the world. According to the World Health Organization(WHO), more than 900 million people are affected by various skin conditions, with skin disorders ranking as the fourth leading cause of nonfatal disease burden worldwide [1]. These diseases range from mild infections to life-threatening chronic disorders.

Skin Neglected Tropical Diseases (NTDs) impose severe health and socioeconomic burdens in impoverished tropical communities. Yet, advancements in AI-driven diagnostic support are hindered by data scarcity, particularly for underrepresented populations and rare manifestations of NTDs. Existing dermatological datasets often lack the demographic and disease spectrum crucial for developing reliable recognition models of NTDs. To address this, we introduce eSkinHealth, a novel dermatological dataset collected on-site in Côte d'Ivoire and Ghana. Specifically, eSkinHealth contains 5,623 images from 1,639 cases and encompasses 47 skin diseases, focusing uniquely on skin NTDs and rare conditions among West African populations. We further propose an AI-expert collaboration paradigm to implement foundation language and segmentation models for efficient generation of multimodal annotations, under dermatologists' guidance. In addition to patient metadata and diagnosis labels, eSkinHealth also includes semantic lesion masks, instance-specific visual captions, and clinical concepts. Overall, our work provides a valuable new resource and a scalable annotation framework, aiming to catalyze the development of more equitable, accurate, and interpretable AI tools for global dermatology.

These same concepts were also used to label 656 skin disease images from the Diverse Dermatology Images dataset, providing an additional external dataset with diverse skin tone representations.

Background: Evaluating AI-generated treatment plans is a key challenge as AI expands beyond diagnostics, especially with new reasoning models. This study compares plans from human experts and two AI models (a generalist and a reasoner), assessed by both human peers and a superior AI judge. Methods: Ten dermatologists, a generalist AI (GPT-4o), and a reasoning AI (o3) generated treatment plans for five complex dermatology cases. The anonymized, normalized plans were scored in two phases: 1) by the ten human experts, and 2) by a superior AI judge (Gemini 2.5 Pro) using an identical rubric. Results: A profound 'evaluator effect' was observed. Human experts scored peer-generated plans significantly higher than AI plans (mean 7.62 vs. 7.16; p=0.0313), ranking GPT-4o 6th (mean 7.38) and the reasoning model, o3, 11th (mean 6.97). Conversely, the AI judge produced a complete inversion, scoring AI plans significantly higher than human plans (mean 7.75 vs. 6.79; p=0.0313). It ranked o3 1st (mean 8.20) and GPT-4o 2nd, placing all human experts lower. Conclusions: The perceived quality of a clinical plan is fundamentally dependent on the evaluator's nature. An advanced reasoning AI, ranked poorly by human experts, was judged as superior by a sophisticated AI, revealing a deep gap between experience-based clinical heuristics and data-driven algorithmic logic. This paradox presents a critical challenge for AI integration, suggesting the future requires synergistic, explainable human-AI systems that bridge this reasoning gap to augment clinical care.

However, there are only a few datasets that include concept-level meta-labels and most of these meta-labels are relevant for natural images that do not require domain expertise. Previous densely annotated datasets in medicine focused on meta-labels that are relevant to a single disease such as osteoarthritis or melanoma. In dermatology, skin disease is described using an established clinical lexicon that allow clinicians to describe physical exam findings to one another. To provide the first medical dataset densely annotated by domain experts to provide annotations useful across multiple disease processes, we developed SkinCon: a skin disease dataset densely annotated by dermatologists. SkinCon includes 3230 images from the Fitzpatrick 17k skin disease dataset densely annotated with 48 clinical concepts, 22 of which have at least 50 images representing the concept.