Advancing AI in dermatology: Enhancing virtual agents with visual and cultural diversity
Exploring the impact of ethnic and cultural representation in AI-driven dermatology training and practice (Issue #244, 1,400 words, 7 minutes)
The authors of a new paper published in Frontiers in Virtual Reality argue that comprehensive diversity in virtual agents is indispensable for achieving virtual reality (VR) acceptance in dermatology and accurately connecting virtual representations to real-world patients.
As VR technology becomes increasingly utilized in dermatologic diagnosis, treatment, and training, it is necessary to ensure that virtual agent simulation representations reflect diverse populations.
Virtual agents incorporate machine learning, natural language processing, and other technologies to create conversational AI. They can also include 3D-modelled virtual people and be used to simulate speaking with a patient.
The paper's authors explain, through a literature review, that virtual agents developed for dermatology should represent a wide range of ethnicities, genders, skin tones, and other relevant physical characteristics.
A lack of comprehensive diversity can lead to misdiagnosis, inaccurate treatments, and poor medical outcomes. Capturing the nuances of how skin conditions manifest across populations through inclusive agents is vital for proper patient care.
They note that a high degree of cultural sensitivity and ethical aspects must be considered when designing virtual agents. Respectful, non-stereotypical representations of diverse populations avoid discrimination and build trust. Preserving cultural identity is central to making VR applications appealing and inclusive for doctors and patients. Such ethical aspects should not be underestimated, the researchers write, as this will strongly influence long-term acceptance and the ultimate success of VR applications in medicine.
On the technical side, the authors note that comprehensively modelling the wide range of skin tones, textures, lesions, scars, and other variations requires advanced algorithms and AI. Manual selection, creation, and design efforts are also needed to ensure accurate and inclusive representations.
However, accessibility is also crucial. The tools for developing and training these agents must be usable by dermatologists regardless of how much 3d modelling expertise the physician might have.
The authors suggest that further research should also explore incorporating age in virtual agent design. This should address the changes skin undergoes during aging, including atrophy, wrinkling, and other age-related variations.
Bottom line: As VR technology is being adopted into dermatology training and practice, it is becoming increasingly important that the virtual agents used are representative of the diversity of patient populations. There remain technical challenges in this field, including making the development tools accessible enough for physicians not trained in 3D modelling. Other technological aspects can effectively contribute to the development and refinement of virtual tools.
From the literature on dermatology in skin of colour
Representations of skin tone and sex in dermatology by generative artificial intelligence: a comparative study
The authors of this paper note that with generative artificial intelligence demonstrating potential in dermatologic education, assessment of skin tone diversity is imperative to ensure comprehensive patient care.
To evaluate the generative AI systems DALL-E3, Midjourney, and DreamStudio Beta, researchers generated five images for eight common dermatologic conditions designated by the American Academy of Dermatology. The investigators used the Massey-Martin Skin Colour Scale to evaluate the images, and a non-rater assessed interrater reliability. Sex determination was based on identifying features.
Of 120 generated images, 88 (73.3%) had concordant skin tone ratings, and 109 (90.8%) displayed an identifiable sex. Of the 88 images, 85 (96.6%) were rated light-toned, three (3.4%) were rated medium-toned, and zero were rated dark-toned. Of the 109 images, 74 (68%) were male, and 35 (32%) were female.
In their conclusion, the authors write that their findings highlight biases in common AI platforms and underscore the need for AI algorithms to address skin tone and sex biases as they continue to increase in popularity.
Fitzpatrick skin type self-reporting versus provider reporting: A single-centre, survey-based study
This survey-based study was offered to all adult patients 18 or older, dermatology residents, and dermatology faculty providers at the University of Oklahoma Dermatology Clinic in Oklahoma City. A biostatistician then analyzed de-identified information from the patient survey, provider-assigned Fitzpatrick skin type (FST), and provider credentials.
Researchers found that the provider-assigned FST was more accurate than the patient's estimation of their ability to tan versus burn. The patient's race was essential in a discrepancy between the provider and the patient, who described FST. Additionally, provider years in practice increased the odds of any discrepancy existing.
The authors conclude that despite being the most used skin tone classification system in dermatology, the FST system has many limitations. The classification system needs to be reevaluated or replaced with methods that more accurately, appropriately, and reliably describe skin tones and photoreactivity. Current trainees must be educated to avoid erroneous use of classifications such as the FST.
Rethinking the use of population descriptors in dermatology trials and beyond: Disentangling race and ethnicity from skin colour
The authors of this paper note that race and ethnicity as population descriptors in research and clinical practice have often been a subject of debate, drawing heightened scrutiny in recent years. Oversimplification and misapplication of these descriptors fail to capture the complexity of human health and genetic diversity.
This paper reports on the Skin of Colour Society's second Meeting the Challenge Summit, attended by over 100 U.S. and international participants. The Summit highlighted several key themes:
The need for transparency in the rationale behind using population descriptors and decision-making processes
Recognizing the role of race and racism in dermatology
Exploring the intersection of dermatology, skin colour, and cultural influences
Understanding the context of population descriptor usage
Developing improved, objective tools for classifying skin colour
Advancing research and creating guidelines
The authors conclude that more specific descriptors, such as skin colour, alongside socially determined factors, will be crucial in achieving meaningful diversity and inclusivity in clinical research.
VIDEO: What is the role of AI in dermatology?
Las Vegas-based dermatologist David Cotter, MD, PhD, says artificial intelligence (AI) has great potential in dermatology. Still, dermatology healthcare providers must take the lead in assessing technology, adopting appropriate offerings, and warning against potentially dangerous programs and strategies.
At the intersection of skin and society
Researchers from Roswell Park Comprehensive Cancer Center in Buffalo, N.Y., will report their latest findings to colleagues worldwide at the 2025 annual American Association for Cancer Research (AACR) meeting in Chicago, April 25 to 30, 2025. The conference brings together more than 21,000 professionals from the oncology field—as well as patients, survivors and advocates—to share and learn about recent discoveries.
According to a press release, one of the invited talks discusses meeting the needs of Indigenous communities.
In 2020, Rodney Haring, PhD, MSW, launched the first U.S. centre for Indigenous cancer research at Roswell Park. Now Chair of the Department of Indigenous Cancer Health at Roswell Park, he traced the expanding scope of his department’s influence during his invited talk “Nation to nation to cancer centers: Exemplars of sovereignty across the cancer care continuum” on Wednesday, April 30.
“Our work isn’t just research,” says Dr. Haring, an enrolled member of the Seneca Nation of Indians (Beaver Clan), in the release. “It’s also service, education, patient navigation and creating opportunities for the next generation of cancer scientists.” He adds that other cancer centres in North America, Australia, and New Zealand have begun creating partnerships with Indigenous nations to address tribal needs and priorities in their respective areas.
“It’s important to talk about what is important to our communities and how we have embedded those priorities into our work, to learn what our colleagues at other sites and centers are doing, to share what we’re doing,” notes Dr. Haring. “All the knowledge that comes back to us goes back to our communities, across the U.S. and beyond.”
This week
May 5 is National Day of Awareness for Missing and Murdered Indigenous Women, Girls and 2SLGBTQQIA+ in Canada
May 5 is African World Heritage Day
May 10 is World Lupus Day
Something to think about in the week ahead . . .
—Hugh Blair (1718 – 1800), Scottish theologian
Next week
A team of Canadian dermatologists have conducted a cross-sectional study of diversity among dermatology leadership in Canada.
Last chance to register for the 3rd annual Summit on Atopic Dermatitis
The 2025 Summit on Atopic Dermatitis virtual conference will be held this Saturday, May 10.
Chaired by Dr. Marissa Joseph (Toronto), the Summit on Atopic Dermatitis will address the unmet need for education among healthcare providers on the incidence of AD and the latest therapies.
Leading experts will provide insights and explore current trends and emerging treatment options.
This year’s faculty include:
Dr. Joseph Lam (Vancouver)
Dr. Feras Al-Ghazawi (Ottawa)
Dr. Zainab Abdurrahman (Toronto)
Dr. Luis Fernando Sanchez-Espino (Edmonton)
Dr. Jaggi Rao (Edmonton)
Dr. Maria Cecilia Rivitti Machado (São Paulo)
Date: Saturday, May 10, 2025
Time: 10:00 AM to 1:00 PM ET
Location: Virtual (Zoom)
Cost: Free of charge
If you enjoy Skin Spectrum Weekly, why not check out the Chronicle’s other publications, podcasts, and portals?
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
Dr. Ruth Ann Vleugels (Boston) describes emerging treatments for dermatomyositis associated with lupus.
Drs. Charles Lynde (Markham, Ont.), Fiona Lovegrove (London, Ont.), Julien Ringuet (Quebec), and Kerri Purdy (Halifax) review new dermatologic therapies to watch in 2025.
Dr. Susan Poelman (Calgary) summarizes current research into treatments for hidradenitis suppurativa and discusses why physicians should be optimistic about the future of managing this disease.
Plus regular features, including the popular column “Vender on Psoriasis” by dermatologist Dr. Ron Vender.
You can read a recent digital edition of The Chronicle of Skin & Allergy here. To apply for a complimentary subscription or to request a sample copy, please email health@chronicle.org with your contact information.
The Women in Dermatology e-newsletter updates readers with new findings concerning dermatologic issues affecting women and the female dermatologists who care for them. Read the current issue here.
Season three of the Vender on Psoriasis podcast with Dr. Ron Vender has begun. Listen to the new season here. In episode five, Dr. Vender discusses whether vitamin D influences psoriasis severity, sex differences in psoriatic inflammation and itch, and the risk of psychiatric disorders associated with acitretin.
And if you’re looking for a web destination for all things derm, visit derm.city, “Where Dermatology Lives.” Please like, rate, review, and share it with your colleagues.
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