Psoriasis severity classification based on adaptive multi-scale features for multi-severity disease

Psoriasis is a skin disease that causes lesions of various sizes across the body and can persist for years with cyclic deterioration and improvement. During treatment, and a multiple-severity disease, with irregular severity within the observation area may be found. The current psoriasis evaluation is based on the subjective evaluation criteria of the clinician using the psoriasis area and severity index (PASI). We proposed a novel psoriasis evaluation method that detects representative regions as evaluation criteria, and extracts severity features to improve the evaluation performance of various types of psoriasis, including multiple-severity diseases. We generated multiple-severity disease images using CutMix and proposed a hierarchical multi-scale deformable attention module (MS-DAM) that can adaptively detect representative regions of irregular and complex patterns in multiple-severity disease analyses. EfficientNet B1 with MS-DAM exhibited the best classification performance with an F1-score of 0.93. Compared with the performance of the six existing self-attention methods, the proposed MS-DAM showed more than 5% higher accuracy than that of multiscale channel attention module (MS-CAM). Using the gradient-weighted activation mapping method, we confirmed that the proposed method works at par with human visual perception. We performed a more objective, effective, and accurate analysis of psoriasis severity using the proposed method.