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Mitigating Individual Skin Tone Bias in Skin Lesion Classification through Distribution-Aware Reweighting

Paxton, Kuniko, Dehghani, Zeinab, Aslansefat, Koorosh, Thakker, Dhavalkumar, Papadopoulos, Yiannis

arXiv.org Artificial Intelligence

Skin color has historically been a focal point of discrimination, yet fairness research in machine learning for medical imaging often relies on coarse subgroup categories, overlooking individual-level variations. Such group-based approaches risk obscuring biases faced by outliers within subgroups. This study introduces a distribution-based framework for evaluating and mitigating individual fairness in skin lesion classification. We treat skin tone as a continuous attribute rather than a categorical label, and employ kernel density estimation (KDE) to model its distribution. We further compare twelve statistical distance metrics to quantify disparities between skin tone distributions and propose a distance-based reweighting (DRW) loss function to correct underrepresentation in minority tones. Experiments across CNN and Transformer models demonstrate: (i) the limitations of categorical reweighting in capturing individual-level disparities, and (ii) the superior performance of distribution-based reweighting, particularly with Fidelity Similarity (FS), Wasserstein Distance (WD), Hellinger Metric (HM), and Harmonic Mean Similarity (HS). These findings establish a robust methodology for advancing fairness at individual level in dermatological AI systems, and highlight broader implications for sensitive continuous attributes in medical image analysis.



Erasing 'Ugly' from the Internet: Propagation of the Beauty Myth in Text-Image Models

Dinkar, Tanvi, Jiang, Aiqi, Abercrombie, Gavin, Konstas, Ioannis

arXiv.org Artificial Intelligence

Social media has exacerbated the promotion of Western beauty norms, leading to negative self-image, particularly in women and girls, and causing harm such as body dysmorphia. Increasingly content on the internet has been artificially generated, leading to concerns that these norms are being exaggerated. The aim of this work is to study how generative AI models may encode 'beauty' and erase 'ugliness', and discuss the implications of this for society. To investigate these aims, we create two image generation pipelines: a text-to-image model and a text-to-language model-to image model. We develop a structured beauty taxonomy which we use to prompt three language models (LMs) and two text-to-image models to cumulatively generate 5984 images using our two pipelines. We then recruit women and non-binary social media users to evaluate 1200 of the images through a Likert-scale within-subjects study. Participants show high agreement in their ratings. Our results show that 86.5% of generated images depicted people with lighter skin tones, 22% contained explicit content despite Safe for Work (SFW) training, and 74% were rated as being in a younger age demographic. In particular, the images of non-binary individuals were rated as both younger and more hypersexualised, indicating troubling intersectional effects. Notably, prompts encoded with 'negative' or 'ugly' beauty traits (such as "a wide nose") consistently produced higher Not SFW (NSFW) ratings regardless of gender. This work sheds light on the pervasive demographic biases related to beauty standards present in generative AI models -- biases that are actively perpetuated by model developers, such as via negative prompting. We conclude by discussing the implications of this on society, which include pollution of the data streams and active erasure of features that do not fall inside the stereotype of what is considered beautiful by developers.



Fitzpatrick Thresholding for Skin Image Segmentation

Stothers, Duncan, Xu, Sophia, Reeves, Carlie, Gracey, Lia

arXiv.org Artificial Intelligence

Accurate estimation of the body surface area (BSA) involved by a rash, such as psoriasis, is critical for assessing rash severity, selecting an initial treatment regimen, and following clinical treatment response. Attempts at segmentation of inflammatory skin disease such as psoriasis perform markedly worse on darker skin tones, potentially impeding equitable care. We assembled a psoriasis dataset sourced from six public atlases, annotated for Fitzpatrick skin type, and added detailed segmentation masks for every image. Reference models based on U-Net, ResU-Net, and SETR-small are trained without tone information. On the tuning split we sweep decision thresholds and select (i) global optima and (ii) per Fitzpatrick skin tone optima for Dice and binary IoU. Adapting Fitzpatrick specific thresholds lifted segmentation performance for the darkest subgroup (Fitz VI) by up to +31 % bIoU and +24 % Dice on UNet, with consistent, though smaller, gains in the same direction for ResU-Net (+25 % bIoU, +18 % Dice) and SETR-small (+17 % bIoU, +11 % Dice). Because Fitzpatrick skin tone classifiers trained on Fitzpatrick-17k now exceed 95 % accuracy, the cost of skin tone labeling required for this technique has fallen dramatically. Fitzpatrick thresholding is simple, model-agnostic, requires no architectural changes, no re-training, and is virtually cost free. We demonstrate the inclusion of Fitzpatrick thresholding as a potential future fairness baseline.



Application of a Virtual Imaging Framework for Investigating a Deep Learning-Based Reconstruction Method for 3D Quantitative Photoacoustic Computed Tomography

Cam, Refik Mert, Park, Seonyeong, Villa, Umberto, Anastasio, Mark A.

arXiv.org Artificial Intelligence

Quantitative photoacoustic computed tomography (qPACT) is a promising imaging modality for estimating physiological parameters such as blood oxygen saturation. However, developing robust qPACT reconstruction methods remains challenging due to computational demands, modeling difficulties, and experimental uncertainties. Learning-based methods have been proposed to address these issues but remain largely unvalidated. Virtual imaging (VI) studies are essential for validating such methods early in development, before proceeding to less-controlled phantom or in vivo studies. Effective VI studies must employ ensembles of stochastically generated numerical phantoms that accurately reflect relevant anatomy and physiology. Yet, most prior VI studies for qPACT relied on overly simplified phantoms. In this work, a realistic VI testbed is employed for the first time to assess a representative 3D learning-based qPACT reconstruction method for breast imaging. The method is evaluated across subject variability and physical factors such as measurement noise and acoustic aberrations, offering insights into its strengths and limitations.