Proceedings of the 2012 International Conference on Machine Learning and Cybernetics, Xian, 15-17 J uly, 2012

DERMATOLOGICAL DISEASE DIAGNOSIS USING COLOR-SKIN IMAGES

M. SHAMSUL ARIFINI, M. GOLAM KIBRIA2, ADNAN FIROZE " M. ASHRAFUL AMINI, HONG YAN3

1 Computer Vision and Cybernetics Group,SECS,Independent University,Bangladesh

2Department of Computer Science & Engineering,University of Information Technology & Sciences
3 Department of Electronic Engineering,City University of Hong Kong,Hong Kong

E-MAIL: arifin_cham@yahoo.com.golam.kibria@uits.edu.bd.adnan.firoze@gmail.com.aminmdashraful@ieee.org.
h.yan@cityu.edu.hk

Abstract: addresses such complexities of the school of dermatology of

This paper presents an automated dermatological
diagnostic system. Etymologically, dermatology is the medical
discipline of analysis and treatment of skin anomalies. The
system presented is a machine intervention in contrast to human
arbitration into the conventional medical personnel
ideology of dermatological diagnosis. The system works on two
dependent steps - the first detects skin anomalies and the latter
identifies the diseases. The system operates on visual input i.e.
high resolution color images and patient history. In terms of
machine intervention, the system uses color image processing
techniques, k-means clustering and color gradient techniques to
identify the diseased skin. For disease classification, the system
resorts to feedforward backpropagation artificial
networks. The system exhibits a diseased skin detection
accuracy of 95.99% and disease identification accuracy of
94.016% while tested for a total of 2055 diseased areas in 704
skin images for 6 diseases.
Keywords:
Skin anomalies, Color Gradient, Clustering, GLCM,
Dermatology.
1. Introduction
Dermatology is the branch of medical science that is
concerned with diagnosis and treatment of skin based
disorders. The vast spectrum of dermatological disorders
varies geographically and also seasonally due to temperature,
humidity and other environmental factors. Human skin is one
of the most unpredictable and difficult terrains to
automatically synthesize and analyze due to its complexity of
jaggedness, tone, presence of hair and other mitigating
features. Even though there have been several researches
conducted to detect and model human skin using Computer
Vision techniques,very few have concentrated on the medical
paradigm of the problem. Expert diagnostic systems that deal
with dermatological disorders are hard to find in the scholarly
area of Intelligent and Expert Systems. Therefore,our system
medical science.
Even though a substantial amount of work has
undergone in the amalgamation of medicine and computer
science, little research has been conducted that connects
based
computer vision and dermatology and none have taken place
in the subcontinent of South Asia to our knowledge.
Techniques for segmentation of dermatoscopic images
using Stabilized Inverse Diffusion Equations (SIDE) were
introduced by Gao et al. [1]. They focused on segmenting
legions from regular skin surfaces. In their experiment they
used the 6 segmentation procedures to 87 images of Nevi and
neural
Melanomas. Their accuracy using algorithms: MMRF,
MMRFISIDE, MSIDE, Median cut and Adaptive
thresholding in blue channel were 75.29%, 71.76%, 63.5%,
54.77% and 51.5% respectively. A multispectral image
processing techniques in dermatology was proposed by Jalil
[2]. She exposed several approaches in segmenting and
labeling skin anomalies using transformations in the
frequency domain. She found an average accuracy of 86.4%
in detecting skin abnormalities. Two researches that were
close to our very own work presented in this paper were
conducted by Antkowiak [3, 5]. His dataset consisted of 215
dermatological images. He used the Fourier transforms of the
images and used them as features directly to the Artificial
Neural Networks (ANN) and Support Vector Machine (SVM).
He presented a comparative analysis on of his classification
performances based on SVM and ANN Using (SVM,ANN),
.
his disease wise classification were as follows: Acne Vulgaris
(45.1%, 96.1%), Atopic Dermatitis (42.1%, 93.9%),
Granuloma Annulare (42.9%,94.0%),Keloid (55.0%,95.4%),
Melanocytic Nevus (64.1%, 97.4%), Melanoma Maligna
(48.4%,96.8%), Nevus Pilosus (66.1%, 97.4%). Thus, ANN
showed significantly better classification performance.
Similar approaches using ANN were employed by
Agatonovic-Kustrin et al. [4] and Bishop and Beresford [6].
A varied imaging dataset were introduced by du Vivier
[7] and eCureMe [8]. Gniadecka et al. [9] and Delgado

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Gomez et al. [10] introduced specialized neural techniques Disease Acne Eczema Psoriasis Tinea Scabies Vitiligo
Name Corporis
for the detection of Melanoma and Psoriasis. In an extensive
study, Handels et al. [11] introduced techniques to extract Patients 19 18 18 14 26 26
features from visual skin tumors. Hoffmann et al. [12]
focused on diagnosis of skin cancer using neural approaches Number 107 102 105 107 182 101
which was exemplary. of
Pictures
Taken
2. The Dermatological Disease Diagnosis System

The complete methodology of our system is represented

2.2. Image Pre-processing and ROI Detection
in Fig. 1 as a flowchart. The individual steps are modularized
and are often autonomous and sometimes dependent on each
other. In image preprocessing, our task is to segment the
diseased skin from healthy skin and making the system
prepared for the classification stage.
Data Collechon and Image AcqUlS1hon

2.2.1 Cropping the Images

Color Grad!ent Generahon

Clu stenn giThresho 1 ding an d Detechng 0 f the Re g1 on s

The apparent pictures that were taken had objects,
of Interest (ROJ) clothing and humans accessories present in the images. We
had to remove them manually to recreate and refine the
Fealure Extrach 0 n
dataset such that the images contain only - "skin" (both
healthy and diseased).
System Trammg, Teshng and Vahdahon

2.2.2 Color Gradient Generation

Fig. 1. A flowchart of the methodology of our system

We used the modified Sobel operator based on color

2.1. Skin Image Acquisition and Data Collection instead of gray. Let, the gradient of a 2D function Fe(x, y) is
defined as the dependent on co-ordinates x and y. Using this
The fIrst and primary task was to collect necessary data notation, it can be shown that the direction of maximum rate
of patients in order to develop the system. Besides this, the of change of c(x,y) where c is the color image as function of
non-visual data of patient histories had to be collected. Thus, x and y (gx and gy are linear horizontal and vertical gradients)
a specialized doctor was present to validate and record the and is given by the angle in following equation.
external data of the patients such as disease history,feeling in 1 1 2gxy
diseased part of body, elevation of the diseased region etc. ( )
B X,Y = -tan-
2
---=-'---
- -::
gxx-gyy (1)
Some characteristic details of the data collection steps are
given below. The value of the rate of change (i.e. the magnitude of the
• Camera Build: Pansonic Lumix FZ-35
gradient) in the directions given by the elements of 0, is given
by following equation.:
• Focusing: The camera was focused manually to adjust
1

Fo (X, y ) = H [(gxx + gyy ) + (gxx-gyy )cos2B(x,y ) + 2gxy sin2B(x, Y )ly

the variable nature of natural light
• Image Resolution: 12 Megapixels (4000 x 3000 pixels)

• Shutter Speed: 1120 to 11125 seconds (based on natural (2)

lighting)
2.2.3 Labeling the Regions of Interest (ROI) on the Image
• A reference object: (a 50 paisa coin that is standard
After color gradient generation, a threshold was applied
Bangladeshi coin of a diameter of 2.2 centimeters) and k-means clustering was performed on the color gradient.
• Source Institution: Sir Salimullah Medical College and
Then morphological closing was performed on the clusters to
Mitford Hospital,Dhaka,Bangladesh obtain the binary mask and by applying the mask we
• Department: Department of Dermatology segmented the diseased part from the healthy skin. All the
• Patients Participated: 112, details of the data collected is consequent steps are illustrated in Fig. 2.
provided in table I.
TABLE I: DETAILED SAMPLE INFORMATION

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 Proceedings of the 2012 International Conference on Machine Learning and Cybernetics, Xian, 15-17 J uly, 2012

Fig. 3. (a) Original Image with ROI-s Labeled (b) Image with the ROI-s
taken apart (c) Original image with no healthy skin present

However we have used overlapping concentric circles

inside the ROI region to have a more clear idea of the mean
colors present inside the Region of Interest (ROI). The circles
were used as they provide a measure which is rotation
invariant and they were overlapped to attain an attribute of
translation invariance.
(d) (e) (I) Five concentric circles were used to extract the colors
Fig. 2. (a) Original Image (b) Color Gradient of Original Image (c)
features. It is illustrated in Fig. 4.
Averaging Filter applied over (b) to ignore hair or scar (d) Binary Mask
by thresholding and clustering on the image with (c) label (e) Labeled
region of interest (t) Isolated ROI (Region of interest or Diseased Skin)

2.3. Feature extraction

The features are of two types: automated visual features

(from images) and external features (from patient history
forms). The extraction procedures were different for the two.

2.3.1 Automated Visual feature extraction:

The feature collections that were extracted from the

images of the ROI and healthy skin are the following:
• Mean and Standard Deviations of Colors of 3 Color
Channels (R, G and B) ofROI
• Mean and Standard Deviations of Colors of 3 Color
Channels (R, G and B) ofhealthy skin
• Distribution (scattering ofthe ROI-s)
Fig. 4. Mean Color extracted using concentric windows inside the ROI
(the left most arrow represents the mean color of healthy skin)
To compute energy, entropy, contrast and homogeneity
we first computed GLCM for each color channel in each
window. G x G GLCM Pd for a displacement vector d (dx, =

• Area (in mm2 ) dy) is given by Shahbahrami et al. [21]. The (i, j) of Pdis the
• Energy, Entropy, Contrast and Homogeneity from GLCM
number of occurrences of the pair of gray-level i and j which
in each color channel [21]
are a distance "d" apart. The equations for obtaining the 4
features from a GLCM can be found in Shahbahrami et al.
At this point,we have separated the healthy skin and the
[21].
individual ROI-s in structures that contain the images of the
The distribution is how the diseased parts are spread out
RGB components. From the RGB components, we have
from each other from its manifestations. This was done from
computed the mean, variance (standard deviation) of the
calculating the Euclidean distances from one connected
channels individually. Energy, entropy, contrast and
component to another and getting their mean. It can be
homogeneity were computed from the regions by computing
expressed as the following equation (where, every i is a ROI
the gray level co-occurrence matrices (GLCM) in each
in a single image, dis�j is the distance from ROI i to j and m
channel as proposed by Shahbahrami et al. [21]. The
is the total number of ROI-s in an image). This feature
separation of ROI and healthy skin was done using masks as
calculates the "spread" of the ROIs in an image.
shown in Fig. 3.
Thus we can see how the healthy and normal skins were
separated to extract colors from them.

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[m 1
L dist ..
. . . ·-1
Dzstrzbutzon = 1-
Y
X �
ixels
m mm
(3)
The area or size of a ROI is very important to classify
the disease. It was done by fIrst using propping regions over
the labeled ROI-s over the masks generated to detect the
regions of interest. Then we multiplied the area in pixel
with the ratio of pixel to the reference object present in the
images (a 50 paisa coin with 2.2 c.m. in diameter) to fInally
get the area or size of the ROI in milimete?
2.3.2 External features extraction
The features that were collected from the patient history
are the following: diseased body part, elevation and
frequency of occurrence (in months). The diseased body parts
were quantifIed and added manually to the sample
descriptions. Since stereo imaging was not feasible in a
government hospital to take a 3D images, the elevations of
ROIs was taken from the patient history forms. A
should be noted that in the ROC curves: True Positives (TP)
= Correctly detected Regions of Interest (diseased skin),
False Positives (FP) = Incorrectly detected Regions of
Interestlhealthy skin detected as ROI, True Negatives (TN) =
Correctly detected Healthy Skin (since the images are
cropped to contain skin only, the value of this is constant at
100% at all times for our system), False Negatives (FN) =
Incorrectly detected healthy skin (healthy skin contains
ROI/the measure of how much the system was unable to
detect the diseased parts).
From these results (Fig. 5) we see that we fInd the best
"detection of ROI accuracy" at the Color-Gradient threshold
of 0.8 and the accuracies are 86.04% for unsupervised
clustering (Fig. 5-top) and 92.25% for semi-supervised (user
inputted number of ROI) clustering (Fig. 5-bottom).
Consequently, we therefore choose the semi-supervised
clustering for further validation since it exhibited an
improved detection rate over the unsupervised system.
ROC Curves varying over Color Gradient Threshold
(unsupervised system)
100.00 --True
.. Positive %
s::: 80.00
u

.. --False
dermatologist assisted in this regard. Elevation refers to the E 60.00 h,.,f-------''"'''
-' 'o;----1:-.JII'
;:- '-- '' OO.5 3 Positive %
a
depth or height of the diseased lesion or region of interest 1; --True
Negative %
40.00
Q.
(ROI). Naturally as it is a length that was measured and the 20.00 --False
unit was in millimeter. Negative %
0 .00
--Accuracy%
0.10 0.20 0.30 0.40 0.50 0.60 0.70 0.80 0.90 1.00
2.4. System Training and Testing Color Gradient

We have used feed-forward back-propagation neural ROC Curves varying over Color Gradient Threshold (semi­
supervised system)
network training to perform this step. We validated and tested
our system using the tenfold cross validation process. The 100.00 -- True
Positive %
virtue of using a cross validation technique was that there ..
� 80.00
-- False
were no overlapping of the test data and training data,making Positive %
..
E
(; 60.00
the system testing results viable and dependable.
1:
-- True
Negative %
8'.. 40.00

--False
20.00 Negative %

3. Experimental results and discussion

0.00
-- Accuracy%

0.10 0.20 0.30 0.40 0.50 0.60 0.70 0 .80 0.90 1.00
The selection of an optimized threshold of Color Gradient
color-gradient and neuron number of the feed-forward
back-propagation ANN was tested with different Fig. 5. ROC curves of ROI detection for varying Color Gradient using
configuration of ANN We have selected our semi-supervised
.
unsupervised clustering (top) and Sami-supervised clustering (bottom)
for Sample size: 2055.
system as it gives us better response than the unsupervised
system and they are discussed in next subsection.
3.2 Classification Performance
3.1. ROC Curves for Optimal Color Gradient Threshold
Upon creation of the training matrix of dimensions 103
x 2055 (2055 samples with 103 features each) and target
The ROC curves in Fig. 5 illustrate the selection of the
matrix of dimension 6 x 2055 (2055 total samples of 6
best threshold. Since the images were cropped to include only
diseases) we were set for tenfold cross validation. We
skin portions, thus in all cases True Negative=100%. It

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partitioned each fold with 10% samples for testing and 90%
samples for training such that upon 10 folds we get
comprehensive accuracy results. We tested our system using
70 neurons growing to 150 neurons in a single hidden layer.
From the plot in Fig. 6 we see that the highest classification
accuracy was found using 98 neurons in the hidden layer and
the accuracy was found to be 94.667%.
Neuron Numbers in Hidden Layervs.
Accuracy (Sample Size: 2055)
3.2.2 Disease Classification Accuracy Evaluation:
We have evaluated our system's performance based on
the sample sizes as weights to signify how well it performs.
Thus, based on table II, we conclude that our system
performs with a classification accuracy of 94.0146% with
training from 2055 samples of 6 diseases and an ANN with
one hidden layer with 98 neurons.

4. Conclusions

In this paper we presented a robust and automated

II
o�o�o � o�o�o�o�o�o
��••��OO""MMMM••�
"""""""""""
Neurons In Hidden Lne,
Fig. 6. Neurous iu hidden layer vs. tenfold cross-validated average
98 Neurons
accuracy folds vs. classification accuracy in aercentage for
(number of neurons for highest classification accuracy)
3.2.1Disease-wise classification peiformance using terifold
cross-validation:
Among our 2055 samples we had 6 diseases. It is to be
noted that every image was not a sample rather every ROI
was a sample in our system, making it more versatile so that
one image containing multiple diseases can also be classified
successfully. The disease-wise accuracy calculation and data
info is presented in table II using 98 neurons in the hidden
layer of our Artificial Neural Network.
method for the diagnosis of dermatological diseases. In brief
it was a challenging task since the human skin is one of the
most difficult surface or terrain to analyze. It is unique and
novel since our dataset was not acquired from secondary
sources; rather it was a work of months of toil in an actual
hospital of Bangladesh making the dataset a standard dataset
which is completely new in perspective of Bangladesh. We
should point out that it is to replace doctors because no
machine can yet replace the human input on analysis and
intuition. Nevertheless, we consider our system as a
significant leap for machine intervention in medicine in
Bangladesh. The system exhibits a diseased skin detection
accuracy of 95.99% and disease identification accuracy of
94.016% while tested for a total of 2055 diseased areas in
704 skin images for 6 diseases.
Acknowledgement
This work is supported by a grant from the Citygroup
Bangladesh (www.citygroup.com.bd).

TABLE II: OVERALL CLASSIFICATION PERFORMANCE GENERATION References

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Disease Sample Size Accuracy X
Sample Size
Armand B. Cognetta. Segmentation of Dermatoscopic
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Acne 405 96.66 % 391.347 Computerized Medical Imaging and Graphics,
Eczema 320 88.00 % 281.6 22(5):375-389 . 1998.
Psoriasis 288 89.33 % 257.2704 [2] Bushra Jalil . Multispectral Image Processing Applied to
T inea 280 88.33 % 247.324 Dermatology. Thesis Submitted for the Degree of MSc.
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Erasmus Mundus in Vision and Robotics (VIBOT).
Scabies 507 98.67% 500.2569
Vitiligo 255 99.67% 254.1585
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Accuracy using (equation 5) = (1931/2055) x 100% = Support Vector Machines for Skin Diseases
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Umea University,Sweden . 2006.

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