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Hierarchical skin lesion image classification with prototypical decision tree.

NPJ Digit Med

January 2025

AIM for Health Lab, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia.

Traditional disease classification models often disregard the clinical significance of misclassifications and lack interpretability. To overcome these challenges, we propose a hierarchical prototypical decision tree (HPDT) for skin lesion classification. HPDT combines prototypical networks and decision trees, leveraging a class hierarchy to guide interpretable predictions from general to specific categories.

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We present an interesting image of eruptive syringoma confirmed by histopathological assessment in a 37-year-old male who was consulted due to numerous brownish small macules and papules resembling maculopapular cutaneous mastocytosis (MPCM). We show difficulties in diagnosing ES, given its rare occurrence and resemblance to other dermatological disorders. Moreover, we discuss the role of dermoscopy and reflectance confocal microscopy in the differential diagnosis of syringoma.

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