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However, their trustworthiness and clinical utility remain limited by three key challenges: heterogeneous datasets with inconsistent diagnostic labels and concept annotations, the lack of grounded diagnostic rationales for reliable reasoning supervision, and limited scalability when transferring knowledge from small, densely annotated datasets to large collections with sparse labels.\n  To address these challenges, we propose Skin-R1, a dermatology-oriented VLM that integrates textbook-grounded clinical reasoning supervision with reinforcement learning (RL) to improve the accuracy and robustness of diagnostic prediction. First, we construct a textbook-based reasoning generator that synthesizes hierarchy-aware and differential-diagnosis (DDx) diagnostic trajectories derived from authoritative dermatology knowle","title":"Skin-R1: Clinical Knowledge-Guided Dermatological Diagnosis Using Vision-Language Models","url":"https://arxiv.org/abs/2511.14900","vendor":"arxiv_cs_ai"},"summary":"arXiv:2511.14900v2 Announce Type: replace-cross \nAbstract: Vision--language models (VLMs) have recently shown promise for assisting clinical reasoning in dermatological diagnosis. However, their trustworthiness and clinical utility remain limited by three key challenges: heterogeneous datasets with inconsistent diagnostic labels and concept annotations, the lack of grounded diagnostic rationales for reliable reasoning supervision, and limited scalability when transferring knowledge from small, densely annotated datasets to large collections with sparse labels.\n  To address these challenges, we propose Skin-R1, a dermatology-oriented VLM that integrates textbook-grounded clinical reasoning supervision with reinforcement learning (RL) to improve the accuracy and robustness of diagnostic prediction. First, we construct a textbook-based reasoning generator that synthesizes hierarchy-aware and differential-diagnosis (DDx) diagnostic trajectories derived from authoritative dermatology knowle","title":"Skin-R1: Clinical Knowledge-Guided Dermatological Diagnosis Using Vision-Language Models","vendor":"arxiv_cs_ai"},"confidence":{"method":"deterministic"},"decision":"POSITIVE","issued_at":"2026-06-30T04:43:04Z","notes":"Spider vendor_press (news) news.vendor_press.v1","object":{"captured_by":"crovia.spider.vendor_press","primary_source_url":"https://arxiv.org/abs/2511.14900"},"predecessors":[],"schema":"crovia.axiom.v1","signature":"ed25519:bc90e1e965f65b0ef348089a7ad4a447a97f323fd9ab1a43c5fc87aac13134b4024e52d009b25d19dc60c8eb96533136a343e91c8ddb3a227d1b4896cfaa8402","signer":"crovia.substrate","subject":{"observed_at":"2026-06-30T04:43:04Z","source_collector":"spider:vendor_press","target_id":"https://arxiv.org/abs/2511.14900"},"tsa":{"authority":"crovia.substrate.bootstrap","rfc3161_token":"{\"kind\":\"crovia.bootstrap.tsa\",\"source_jsonl\":\"/opt/crovia/spider/data/news/vendor_press_v1.jsonl\",\"source_seal_merkle_root\":\"spider_vendor_press_v1\",\"upgrade_path\":\"Sessione H \\u2014 OpenTimestamps weekly anchor\"}"},"zk_mode":"clear","zk_proof":null},"ledger":{"leaf_hash":"f2977318daab5e3180930a124ee803198e6b23da558b061924354359c969fc52","leaf_index":265137,"ledger_path":"/opt/crovia/substrate/axiom_ledger.jsonl"},"merkle_proof":{"hash_alg":"sha256","leaf_prefix":"0x00","node_prefix":"0x01","odd_leaf_rule":"duplicate_last","path":[{"sibling":"8c1f51a55f30bb8175ae6b7057e2ad1b3f0cde592093d3a36fb73c5b082cb54a","side":"left"},{"sibling":"6083f502b1288effc92124154d84dab384e5dfb3f5b540df27fe1a5e1006af2b","side":"right"},{"sibling":"b7992a08540a0cbc19b705b85ba455352a5e0c1ab57728c8dbcf331215f62bd9","side":"right"},{"sibling":"7e8c0f543f1e58d1213453c16412b66b2ea28f54a44d282dbc65560792367d42","side":"right"},{"sibling":"d15d7c0fcf4c5a67d426706865a6516de7b87659e9ac7be3c406c5f7d3ea1a1c","side":"left"},{"sibling":"8b8516ca7e1f9111ab46032dab7698b92b4b373be283ed732992cab7255b0657","side":"left"},{"sibling":"12ff1a08dce5c080a9554f7a9c78a9b47fc8b6f29530b9c180019613291a46eb","side":"right"},{"sibling":"10a48a93a0ff0e4d8f47e9a90582ecaf28e7ec0eb7e47a52bf101e3640d950f9","side":"left"},{"sibling":"3f337e26f1a0c4c64b8b7ebac04427325a7e7838c802c162576de1cd617b91ce","side":"left"},{"sibling":"1549a8883ab3267f958dc2624919e40c65c82958b8005967ed6a4da1247da0ad","side":"left"},{"sibling":"23994bf0974e5c9c7f63a61b4f0a48b0ca756a4adc34a8f85f878e774c37dfbe","side":"right"},{"sibling":"f9b4bed84fa6990c71ad2887c91bda183001f05f6b648f21d1273045a26b11fd","side":"left"},{"sibling":"173d2dc4b29ee04ea41d6d0ebc334c4bc2d46e7ee4230c94765413f24fb4bc42","side":"right"},{"sibling":"112461f7c0ec411116fb5c6c90fe95cea9d8f188b9fe08afe25a837ac02d0071","side":"right"},{"sibling":"ea9488204352c49db8f7daf05eefcd7628ecf9413830346674801a99d0654a94","side":"right"},{"sibling":"6261c13b9922cb657f10d1e5d36ec15d8771cf8766e36c61dcbffb7bed57e396","side":"right"},{"sibling":"fa19aa3faf287618b820bcfceebb366152ad521dd20ef9f51e977816663e448b","side":"right"},{"sibling":"c32f943406b62d1fc59b7f7e243492174c8e1caba8c8a2705f86c773315736e0","side":"right"},{"sibling":"1cecb7f447febd025aac272837c80de218aecc6485d2395a509b2a1f1b9c746e","side":"left"}]},"schema":"crovia.axiom_proof.v1","seal":{"first_collector_run_id":"","first_receipt_hash":"","jsonl_path":"/opt/crovia/substrate/axiom_ledger.jsonl","key_id":"430895f101d38164","last_collector_run_id":"","last_receipt_hash":"","leaf_count":265374,"merkle_root":"9636001ecab173cb6af10dc7c71eb14585daa62f9c0a6f027046f05633156891","public_key_hex":"cf742e26f75669dc673cb5c0786a1ae23ae8ca19c347317192ce40c28a7ff25c","run_id":"hourly_json_retrofit_20260630T053701Z","schema":"crovia.seal.v1","seal_family_version":"crovia-seal-family/1","seal_kind":"substrate_batch","sealed_at":"2026-06-30T05:38:03Z","sig_algorithm":"ed25519","signature":"6d4b8fd9b9da856cbb5fba7540877c6a63fa18a5ec3eaf28dc4d6d1c64921c9c0565f8c95f4b7aec0e7744fd7754844f051baf863db708cad768765b416a7b0c","signer_version":"1.1.0"},"trust_root":{"key_id":"430895f101d38164","public_key_hex":"cf742e26f75669dc673cb5c0786a1ae23ae8ca19c347317192ce40c28a7ff25c","signature_algorithm":"ed25519","url":"/registry/canon/TRUST_ROOT.md"},"verifier":{"spec":"/registry/canon/AXIOM_RECEIPT_v1.md","url":"/v/axm_e448afd46daee3984ba57c8a8c976c655fb98b73d24621e65091f3f1ef5b1507"}}