Towards Scalable Foundation Models for Digital Dermatology

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 clinicians in dermatological applications.

PASSION for Dermatology: Bridging the Diversity Gap with Pigmented Skin Images from Sub-Saharan Africa

Africa faces a huge shortage of dermatologists, with less than one per million people. This is in stark contrast to the high demand for dermatologic care, with 80% of the paediatric population suffering from largely untreated skin conditions. The integration of AI into healthcare sparks significant hope for treatment accessibility, especially through the development of AI-supported teledermatology. Current AI models are predominantly trained on white-skinned patients and do not generalize well enough to pigmented patients. The PASSION project aims to address this issue by collecting images of skin diseases in Sub-Saharan countries with the aim of open-sourcing this data. This dataset is the first of its kind, consisting of 1,653 patients for a total of 4,901 images. The images are representative of telemedicine settings and encompass the most common paediatric conditions: eczema, fungals, scabies, and impetigo. We also provide a baseline machine learning model trained on the dataset and a detailed performance analysis for the subpopulations represented in the dataset. The project website can be found at https://passionderm.github.io/.

Towards Reliable Dermatology Evaluation Benchmarks

Benchmark datasets for digital dermatology unwittingly contain inaccuracies that reduce trust in model performance estimates. We propose a resource-efficient data cleaning protocol to identify issues that escaped previous curation. The protocol leverages an existing algorithmic cleaning strategy and is followed by a confirmation process terminated by an intuitive stopping criterion. Based on confirmation by multiple dermatologists, we remove irrelevant samples and near duplicates and estimate the percentage of label errors in six dermatology image datasets for model evaluation promoted by the International Skin Imaging Collaboration. Along with this paper, we publish revised file lists for each dataset which should be used for model evaluation. Our work paves the way for more trustworthy performance assessment in digital dermatology.

SelfClean: A Self-Supervised Data Cleaning Strategy

Most commonly used benchmark datasets for computer vision contain irrelevant images, near duplicates, and label errors. Consequently, model performance on these benchmarks may not be an accurate estimate of generalization ability. This is a particularly acute concern in computer vision for medicine where datasets are typically small, stakes are high, and annotation processes are expensive and error-prone. In this paper, we propose SelfClean, a general procedure to clean up image datasets exploiting a latent space learned with self-supervision. By relying on self-supervised learning, our approach focuses on intrinsic properties of the data and avoids annotation biases. We formulate dataset cleaning as either a set of ranking problems, where human experts can make decisions with significantly reduced effort, or a set of scoring problems, where decisions can be fully automated based on score distributions. We compare SelfClean against other algorithms on common computer vision benchmarks enhanced with synthetic noise and demonstrate state-of-the-art performance on detecting irrelevant images, near duplicates, and label errors. In addition, we apply our method to multiple image datasets and confirm an improvement in evaluation reliability.