Accurate and timely diagnosis of multi-class skin lesions is hampered by subjective methods, inherent data imbalance in datasets like HAM10000, and the "black box" nature of Deep Learning (DL) models. This study proposes a trustworthy and highly accurate Computer-Aided Diagnosis (CAD) system to overcome these limitations. The approach utilizes Deep Convolutional Generative Adversarial Networks (DCGANs) for per class data augmentation to resolve the critical class imbalance problem. A fine-tuned ResNet-50 classifier is then trained on the augmented dataset to classify seven skin disease categories. Crucially, LIME and SHAP Explainable AI (XAI) techniques are integrated to provide transparency by confirming that predictions are based on clinically relevant features like irregular morphology. The system achieved a high overall Accuracy of 92.50 % and a Macro-AUC of 98.82 %, successfully outperforming various prior benchmarked architectures. This work successfully validates a verifiable framework that combines high performance with the essential clinical interpretability required for safe diagnostic deployment. Future research should prioritize enhancing discrimination for critical categories, such as Melanoma NOS (F1-Score is 0.8602).

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.

The skin is the largest organ in the human body, and approximately a third of the total number of cancer cases are represented by skin cancers. Melanoma is the deadliest form of skin cancer, which is responsible for an overwhelming majority of skin cancer deaths. The number of melanoma deaths is expected to increase by 4.4% in 2023. Although the mortality is significant, when detected e arly, the 5-year survival rate for melanoma is over 99% (American Cancer Society, 2022). Currently, the most accurate way to diagnose melanoma is a biopsy. This is a penetrative surgical procedure that involves higher costs but also incorporates risks of developing various infectious diseases (Lakhtakia et al., 2009). Thus, the usual clinical practice of melanoma diagnosis is visual inspection using Dermoscopy by dermatologists or specially trained clinicians. This approach presents challenges, primarily due to its resource-intensive nature in terms of time and cost. This method's accuracy of melanoma diagnosis is approximately

Early detection of melanoma has grown to be essential because it significantly improves survival rates, but automated analysis of skin lesions still remains challenging. ABCDE, which stands for Asymmetry, Border irregularity, Color variation, Diameter, and Evolving, is a well-known classification method for skin lesions, but most deep learning mechanisms treat it as a black box, as most of the human interpretable features are not explained. In this work, we propose a deep learning framework that both classifies skin lesions into categories and also quantifies scores for each ABCD feature. It simulates the evolution of these features over time in order to represent the E aspect, opening more windows for future exploration. The A, B, C, and D values are quantified particularly within this work. Moreover, this framework also visualizes ABCD feature trajectories in latent space as skin lesions evolve from benign nevuses to malignant melanoma. The experiments are conducted using the HAM10000 dataset that contains around ten thousand images of skin lesions of varying stages. In summary, the classification worked with an accuracy of around 89 percent, with melanoma AUC being 0.96, while the feature evaluation performed well in predicting asymmetry, color variation, and diameter, though border irregularity remains more difficult to model. Overall, this work provides a deep learning framework that will allow doctors to link ML diagnoses to clinically relevant criteria, thus improving our understanding of skin cancer progression. Introduction Melanoma, an aggressive form of skin cancer, is one of the leading causes of death due to skin cancer [6]. Early diagnosis is important because the 5-year survival rate exceeds 90% for early-stage melanoma, but drops below 20% for advanced stages [6]. In order to differentiate between harmful and harmless lesions, dermatologists utilize the ABCDE method. "A" stands for "asymmetry," as malignant skin lesions often appear to be uneven; "B" stands for "border irregularity," as scientists search for jagged or notched edges; "C" If a lesion displays two or more of the attributes described above, the lesion is most likely harmful melanoma.

Cutaneous malignancies demand early detection for favorable outcomes, yet current diagnostics suffer from inter-observer variability and access disparities. While AI shows promise, existing dermatological systems are limited by homogeneous architectures, dataset biases across skin tones, and fragmented approaches that treat natural language processing as separate post-hoc explanations rather than integral to clinical decision-making. We introduce a unified framework that fundamentally reimagines AI integration for dermatological diagnostics through two synergistic innovations. First, a purposefully heterogeneous ensemble of architecturally diverse convolutional neural networks provides complementary diagnostic perspectives, with an intrinsic uncertainty mechanism flagging discordant cases for specialist review -- mimicking clinical best practices. Second, we embed large language model capabilities directly into the diagnostic workflow, transforming classification outputs into clinically meaningful assessments that simultaneously fulfill medical documentation requirements and deliver patient-centered education. This seamless integration generates structured reports featuring precise lesion characterization, accessible diagnostic reasoning, and actionable monitoring guidance -- empowering patients to recognize early warning signs between visits. By addressing both diagnostic reliability and communication barriers within a single cohesive system, our approach bridges the critical translational gap that has prevented previous AI implementations from achieving clinical impact. The framework represents a significant advancement toward deployable dermatological AI that enhances diagnostic precision while actively supporting the continuum of care from initial detection through patient education, ultimately improving early intervention rates for skin lesions.

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.

Manual annotation of medical images is a labor-intensive and time-consuming process, posing a significant bottleneck in the development and deployment of robust medical imaging AI systems. This paper introduces a novel hands-free Human-AI collaborative framework for medical image segmentation that substantially reduces the annotation burden by eliminating the need for explicit manual pixel-level labeling. The core innovation lies in a preference learning paradigm, where human experts provide minimal, intuitive feedback -- simply indicating whether an AI-generated segmentation is better or worse than a previous version. The framework comprises four key components: (1) an adaptable foundation model (FM) for feature extraction, (2) label propagation based on feature similarity, (3) a clicking agent that learns from human better-or-worse feedback to decide where to click and with which label, and (4) a multi-round segmentation learning procedure that trains a state-of-the-art segmentation network using pseudo-labels generated by the clicking agent and FM-based label propagation. Experiments on three public datasets demonstrate that the proposed approach achieves competitive segmentation performance using only binary preference feedback, without requiring experts to directly manually annotate the images.

Accepted Manuscript: This is the peer - reviewed version of the article accepted for publication in Computers in Biology and Medicine . This manuscript version is made available under the CC BY - NC - ND license. Abstract In dermoscopic images, which allow visualization of surface skin structures not visible to the naked eye, lesion shape offers vital insights into skin diseases. In clinically practiced methods, asymmetric lesion shape is one of the criteria for diagnosing M elanoma. Initially, we labeled data for a non - annotated dataset with symmetrical information based on clinical assessments . Subsequently, we propose a supporting technique -- a supervised learning image processing algorithm -- to analyze the geometrical pattern of lesion shape, aiding non - experts in understanding the criteria of an asymmetric lesion. We then utilize a pre - trained convolutional neural network (CNN) to extract shape, color, and texture features from dermoscopic images for training a multiclass support vector machine (SVM) classifier, outperforming state - of - the - art methods from the literature. In the geometry - based experiment, we achieved a 99.00% detection rate for dermatological asymmetric lesions. In the CNN - based experiment, the best performance is found 9 4% Kappa Score, 95% Macro F1 - score, and 97 % weighted F1 - score for classifying lesion shapes ( A symmetric, H alf - S ymmetric, and S ymmetric). Introduction Dermatological asymmetry, a cornerstone in skin lesion assessment, refers to disparities observed in the shape, size, or color of moles or lesions [1, 2, 3] . In dermatology, careful examination of the lesion shape is critical, especially when it comes to the possibility that lesions are cancerous, such as Melanoma. The dermatological three - point - checklist for early skin cancer detection has showcased remarkable sensitivity in identifying Melanoma [ 2 ]. The presence of " asymmetry of color and structure in one or two perpendicular axes ", stands as the initial criterion of this checklist [ 2 ]. In this method, asymmetry evaluation entails scrutinizing lesions within a plane bisected by two axes set at 90, assigning a score ranging from 0 to 2 based on the number of axes exhibiting asymmetry in shape, color, or structure.

The rapid advancement of deep learning in medical image analysis has greatly enhanced the accuracy of skin cancer classification. However, current state-of-the-art models, especially those based on transfer learning like ResNet50, come with significant computational overhead, rendering them impractical for deployment in resource-constrained environments. This study proposes a custom CNN model that achieves a 96.7\% reduction in parameters (from 23.9 million in ResNet50 to 692,000) while maintaining a classification accuracy deviation of less than 0.022\%. Our empirical analysis of the HAM10000 dataset reveals that although transfer learning models provide a marginal accuracy improvement of approximately 0.022\%, they result in a staggering 13,216.76\% increase in FLOPs, considerably raising computational costs and inference latency. In contrast, our lightweight CNN architecture, which encompasses only 30.04 million FLOPs compared to ResNet50's 4.00 billion, significantly reduces energy consumption, memory footprint, and inference time. These findings underscore the trade-off between the complexity of deep models and their real-world feasibility, positioning our optimized CNN as a practical solution for mobile and edge-based skin cancer diagnostics.

Artificial intelligence has significantly advanced skin cancer diagnosis by enabling rapid and accurate detection of malignant lesions. In this domain, most publicly available image datasets consist of single, isolated skin lesions positioned at the center of the image. While these lesion-centric datasets have been fundamental for developing diagnostic algorithms, they lack the context of the surrounding skin, which is critical for improving lesion detection. The iToBoS dataset was created to address this challenge. It includes 16,954 images of skin regions from 100 participants, captured using 3D total body photography. Each image roughly corresponds to a $7 \times 9$ cm section of skin with all suspicious lesions annotated using bounding boxes. Additionally, the dataset provides metadata such as anatomical location, age group, and sun damage score for each image. This dataset aims to facilitate training and benchmarking of algorithms, with the goal of enabling early detection of skin cancer and deployment of this technology in non-clinical environments.