Evidence mapPaperPMID 42438416Full record

ArticleAnnals of medicine2026

A deep learning framework for recognizing skin changes secondary to chronic venous insufficiency in clinical photographs: a multicentre validation study.

Ko Eun Kim, Yerin Lee, Hyunyoung Kang, Dai Hyun Kim, Hwan Kyu Roh, Sejung Yang, Beom Suk Kim

Abstract readMulticenter StudyValidation Study
In one paragraph

Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Ko Eun KimDepartment of Dermatology, Korea University Guro Hospital, Seoul, Republic of Korea.ORCID 0000-0002-4141-204X
Yerin LeeDepartment of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.ORCID 0000-0001-5450-6734
Hyunyoung KangDepartment of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.ORCID 0009-0004-2841-5416
Dai Hyun KimDepartment of Dermatology, College of Medicine, Korea University, Seoul, Republic of Korea.ORCID 0000-0002-3546-2366
Hwan Kyu RohHeartwell Vein Clinic, Seoul, Republic of Korea.
Sejung YangDepartment of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.ORCID 0000-0002-5841-851X
Beom Suk KimDepartment of Physical and Rehabilitation Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.ORCID 0000-0003-4972-9508

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic venous insufficiency (CVI) produces heterogeneous lower-extremity skin changes that often mimic inflammatory dermatoses, complicating the differentiation between venous etiologies and conditions requiring dermatologic care. Coexisting venous signs further confound visual interpretation, leading to diagnostic variability. To address this unmet clinical need, we developed and externally validated a pose-guided, high-resolution deep learning pipeline to classify CVI-related skin lesions from routine clinical photographs. MATERIALS AND

methodsA deep learning framework was developed using a multicentre dataset (8672 images) from Korea University Guro Hospital, Chung-Ang University Gwangmyeong Hospital and Heartwell Vein Clinic. The pipeline integrated Sapiens-based pose estimation for limb localization and a U-Net model refined with Segment Anything Model 2 (SAM2) for skin segmentation. Multiple backbone architectures were evaluated, and ResNet-34 was selected based on optimal performance, taking refined masks and RGB images as input. Performance was evaluated on an internal test set, an independent clinical dataset (

resultsResNet-34 emerged as the optimal architecture, achieving an internal AUROC of 0.922 with balanced sensitivity (0.679) and specificity (0.943) at 1024 × 1024 resolution. Pose-guided skin segmentation improved discrimination compared to using raw images (AUROC 0.920) or skin masking alone (AUROC 0.905). Multicentre training enhanced generalizability, yielding an external AUROC of 0.877 and maintaining high performance on the Fitzpatrick17k dataset (sensitivity 0.918).

conclusionsOur pose-guided, high-resolution pipeline enables robust, objective detection of CVI-related skin lesions. By demonstrating high generalizability across multicentre and public datasets, this framework serves as a reliable decision-support tool to standardize clinical phenotyping and facilitate consistent triage and management of chronic venous disease across diverse care settings.

Indexed as

Deep LearningPhotographySkinSkin DiseasesVenous InsufficiencyChronic DiseaseHumansImage Interpretation, Computer-AssistedChronic venous diseasecomputer-assisted decision makinglipodermatosclerosispose estimationskin segmentationstasis dermatitis

Identifiers

PMID42438416
PMCPMC13366648

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