Deep Learning Image Processing Models in Dermatopathology

Dermatopathology has rapidly advanced due to the implementation of deep learning models and artificial intelligence (AI). From convolutional neural networks (CNNs) to transformer-based foundation models, these systems are now capable of accurate whole-slide analysis and multimodal integration. This review synthesizes the most recent advents of deep-learning architecture and synthesizes its evolution from first-generation CNNs to hybrid CNN-transformer systems to large-scale foundational models such as Paige's PanDerm AI and Virchow. Herein, we examine performance benchmarks from real-world deployments of major dermatopathology deep learning models (DermAI, PathAssist Derm), as well as emerging next-generation models still under research and development. We assess barriers to clinical workflow adoption such as dataset bias, AI interpretability, and government regulation. Further, we discuss potential future research directions and emphasize the need for diverse, prospectively curated datasets, explainability frameworks for trust in AI, and rigorous compliance to Good Machine-Learning-Practice (GMLP) to achieve safe and scalable deep learning dermatopathology models that can fully integrate into clinical workflows.