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Background  The emergence of the deep convolutional neural network (CNN) greatly improves the quality of computer-aided supporting systems. However, due to the challenges of generating reliable and timely results, clinical adoption of computer-aided diagnosis systems is still limited. Recent informatics research indicates that machine learning algorithms need to be combined with sufficient clinical expertise in order to achieve an optimal result.    Methods  In this research, we used deep learning algorithms to help diagnose four common cutaneous diseases based on dermoscopic images. In order to facilitate decision-making and improve the accuracy of our algorithm, we summarized classification/diagnosis scenarios based on domain expert knowledge and semantically represented them in a hierarchical structure.    Results  Our algorithm achieved an accuracy of 87.25 ± 2.24% in our test dataset with 1067 images. The semantic summarization of diagnosis scenarios can help further improve the algorithm to facilitate future computer-aided decision support.    Conclusions  In this paper, we applied deep neural network algorithm to classify dermoscopic images of four common skin diseases and archived promising results. Based on the results, we further summarized the diagnosis/classification scenarios, which reflect the importance of combining the efforts of both human expertise and computer algorithms in dermatologic diagnoses.

Towards improving diagnosis of skin diseases by combining deep neural network and human knowledge