The surge in developing deep learning models for diagnosing skin lesions through image analysis is notable, yet their clinical black faces challenges. Current dermatology AI models have limitations: limited number of possible diagnostic outputs, lack of real-world testing on uncommon skin lesions, inability to detect out-of-distribution images, and over-reliance on dermoscopic images. To address these, we present an All-In-One \textbf{H}ierarchical-\textbf{O}ut of Distribution-\textbf{C}linical Triage (HOT) model. For a clinical image, our model generates three outputs: a hierarchical prediction, an alert for out-of-distribution images, and a recommendation for dermoscopy if clinical image alone is insufficient for diagnosis. When the recommendation is pursued, it integrates both clinical and dermoscopic images to deliver final diagnosis. Extensive experiments on a representative cutaneous lesion dataset demonstrate the effectiveness and synergy of each component within our framework. Our versatile model provides valuable decision support for lesion diagnosis and sets a promising precedent for medical AI applications.

通过图像分析开发深度学习模型诊断皮肤病变的激增值得注意，然而它们在临床黑脸挑战方面存在限制：限定的诊断输出数量、对罕见皮肤病变缺乏实际世界测试、无法检测越界图像以及过度依赖显微镜图像。为了解决这些问题，我们提出了一种全能的HOT模型（Hierarchical-Out of Distribution-Clinical Triage），对于临床图像，我们的模型生成三个输出：层次预测、越界图像警报以及在临床图像不足以进行诊断时对显微镜图像的推荐。当进行推荐时，它将同时整合临床和显微镜图像以进行最终诊断。针对代表性的皮肤病变数据集进行的大量实验证明了我们框架内每个组件的有效性和协同作用。我们多功能的模型为病变诊断提供有价值的决策支持，并为医学AI应用设定了一个有前景的先例。

皮肤病诊断的AI模型改进：克服关键挑战提升皮肤病变诊断能力