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Main Authors: Liu, Zehao, Ren, Wejieying, Zhang, Jipeng, Zhao, Tianxiang, Zhu, Jingxi, Li, Xiaoting, Honavar, Vasant G.
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2511.14900
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author Liu, Zehao
Ren, Wejieying
Zhang, Jipeng
Zhao, Tianxiang
Zhu, Jingxi
Li, Xiaoting
Honavar, Vasant G.
author_facet Liu, Zehao
Ren, Wejieying
Zhang, Jipeng
Zhao, Tianxiang
Zhu, Jingxi
Li, Xiaoting
Honavar, Vasant G.
contents The emergence of vision-language models (VLMs) has opened new possibilities for clinical reasoning and has shown promising performance in dermatological diagnosis. However, their trustworthiness and clinical utility are often limited by three major factors: (1) Data heterogeneity, where diverse datasets lack consistent diagnostic labels and clinical concept annotations; (2) Absence of grounded diagnostic rationales, leading to a scarcity of reliable reasoning supervision; and (3) Limited scalability and generalization, as models trained on small, densely annotated datasets struggle to transfer nuanced reasoning to large, sparsely-annotated ones. To address these limitations, we propose SkinR1, a novel dermatological VLM that combines deep, textbook-based reasoning with the broad generalization capabilities of reinforcement learning (RL). SkinR1 systematically resolves the key challenges through a unified, end-to-end framework. First, we design a textbook-based reasoning generator that synthesizes high-fidelity, hierarchy-aware, and differential-diagnosis (DDx)-informed trajectories, providing reliable expert-level supervision. Second, we leverage the constructed trajectories for supervised fine-tuning (SFT) empowering the model with grounded reasoning ability. Third, we develop a novel RL paradigm that, by incorporating the hierarchical structure of diseases, effectively transfers these grounded reasoning patterns to large-scale, sparse data. Extensive experiments on multiple dermatology datasets demonstrate that SkinR1 achieves superior diagnostic accuracy. The ablation study demonstrates the importance of the reasoning foundation instilled by SFT.
format Preprint
id arxiv_https___arxiv_org_abs_2511_14900
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Skin-R1: Toward Trustworthy Clinical Reasoning for Dermatological Diagnosis
Liu, Zehao
Ren, Wejieying
Zhang, Jipeng
Zhao, Tianxiang
Zhu, Jingxi
Li, Xiaoting
Honavar, Vasant G.
Computer Vision and Pattern Recognition
Artificial Intelligence
Computation and Language
The emergence of vision-language models (VLMs) has opened new possibilities for clinical reasoning and has shown promising performance in dermatological diagnosis. However, their trustworthiness and clinical utility are often limited by three major factors: (1) Data heterogeneity, where diverse datasets lack consistent diagnostic labels and clinical concept annotations; (2) Absence of grounded diagnostic rationales, leading to a scarcity of reliable reasoning supervision; and (3) Limited scalability and generalization, as models trained on small, densely annotated datasets struggle to transfer nuanced reasoning to large, sparsely-annotated ones. To address these limitations, we propose SkinR1, a novel dermatological VLM that combines deep, textbook-based reasoning with the broad generalization capabilities of reinforcement learning (RL). SkinR1 systematically resolves the key challenges through a unified, end-to-end framework. First, we design a textbook-based reasoning generator that synthesizes high-fidelity, hierarchy-aware, and differential-diagnosis (DDx)-informed trajectories, providing reliable expert-level supervision. Second, we leverage the constructed trajectories for supervised fine-tuning (SFT) empowering the model with grounded reasoning ability. Third, we develop a novel RL paradigm that, by incorporating the hierarchical structure of diseases, effectively transfers these grounded reasoning patterns to large-scale, sparse data. Extensive experiments on multiple dermatology datasets demonstrate that SkinR1 achieves superior diagnostic accuracy. The ablation study demonstrates the importance of the reasoning foundation instilled by SFT.
title Skin-R1: Toward Trustworthy Clinical Reasoning for Dermatological Diagnosis
topic Computer Vision and Pattern Recognition
Artificial Intelligence
Computation and Language
url https://arxiv.org/abs/2511.14900