Abstract-- Vision-Language Models (VLMs) show promise in medical image analysis, yet their capacity for structured reasoning in complex domains like dermatology is often limited by data scarcity and the high computational cost of advanced training techniques. To address these challenges, we introduce DermIQ-VLM, a VLM developed through a multi-stage, resource-efficient methodology designed to emulate a dermatologist's diagnostic process. Our primary contribution is a modified version of Grouped Relative Policy Optimization (GRPO), called GRPO++, which stabilizes the powerful but data-intensive GRPO framework. Our proposed training pipeline first employs GRPO++ for reasoning-oriented disease recognition, followed by supervised fine-tuning for conversational ability. To mitigate factual errors introduced during this step, we then align the model using Direct Preference Optimization (DPO), leveraging a Knowledge Graph-based system as a scalable proxy for expert preference. A preliminary evaluation on a curated dermatological dataset demonstrates that our proposed methodology yields notable performance gains over standard fine-tuning approaches.

Image classification usually requires connectivity and access to the cloud which is often limited in many parts of the world, including hard to reach rural areas. TinyML aims to solve this problem by hosting AI assistants on constrained devices, eliminating connectivity issues by processing data within the device itself, without internet or cloud access. This pilot study explores the use of tinyML to provide healthcare support with low spec devices in low connectivity environments, focusing on diagnosis of skin diseases and the ethical use of AI assistants in a healthcare setting. To investigate this, 10,000 images of skin lesions were used to train a model for classifying visually detectable diseases (VDDs). The model weights were then offloaded to a Raspberry Pi with a webcam attached, to be used for the classification of skin lesions without internet access. It was found that the developed prototype achieved a test accuracy of 78% and a test loss of 1.08.

Skin cancer is a treatable disease if discovered early. We provide a production-specific solution to the skin cancer classification problem that matches human performance in melanoma identification by training a vision transformer on melanoma medical images annotated by experts. Since inference cost, both time and memory wise is important in practice, we employ knowledge distillation to obtain a model that retains 98.33% of the teacher's balanced multi-class accuracy, at a fraction of the cost. Memory-wise, our model is 49.60% smaller than the teacher. Time-wise, our solution is 69.25% faster on GPU and 97.96% faster on CPU. By adding classification heads at each level of the transformer and employing a cascading distillation process, we improve the balanced multi-class accuracy of the base model by 2.1%, while creating a range of models of various sizes but comparable performance.

Deep learning-based diagnostic system has demonstrated potential in classifying skin cancer conditions when labeled training example are abundant. However, skin lesion analysis often suffers from a scarcity of labeled data, hindering the development of an accurate and reliable diagnostic system. In this work, we leverage multiple skin lesion datasets and investigate the feasibility of various unsupervised domain adaptation (UDA) methods in binary and multi-class skin lesion classification. In particular, we assess three UDA training schemes: single-, combined-, and multi-source. Our experiment results show that UDA is effective in binary classification, with further improvement being observed when imbalance is mitigated. In multi-class task, its performance is less prominent, and imbalance problem again needs to be addressed to achieve above-baseline accuracy. Through our quantitative analysis, we find that the test error of multi-class tasks is strongly correlated with label shift, and feature-level UDA methods have limitations when handling imbalanced datasets. Finally, our study reveals that UDA can effectively reduce bias against minority groups and promote fairness, even without the explicit use of fairness-focused techniques.