{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:12:59Z","timestamp":1788228779658,"version":"build-2803163510"},"reference-count":74,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Artificial intelligence (AI) has emerged as a transformative technology across dermatological practice, from automated lesion classification to whole-slide pathology analysis. Despite rapid growth in primary studies, a comprehensive synthesis of diagnostic performance, application breadth, and real-world implementation remains lacking. Methods: We conducted a PRISMA systematic review and meta-analysis of studies published from January 2000 to March 2025. We searched the PubMed, Cochrane, and ScienceDirect databases for studies reporting AI diagnostic performance in dermatology. Results: Of 30 included studies (28 valid after exclusion of two retracted publications), 60% focused on melanoma and related lesions. AI diagnostic performance improved markedly over five identified temporal eras (2003\u20132025), with a pooled AUROC of 0.92 (95% CI 0.87\u20130.96), Reitsma sensitivity of 0.88 (0.82\u20130.93), and Reitsma specificity of 0.85 (0.75\u20130.91). AI matched or surpassed specialist dermatologists in 71% of direct comparisons. Three randomized controlled trials (RCTs) were identified, with heterogeneous findings across different clinical applications: AI assistance significantly improved non-expert diagnostic accuracy in one trial (53.9% vs. 43.8%; p = 0.019), significantly reduced acne severity via personalized treatment recommendations in a second, and showed non-inferior diagnostic performance, but was not cost-effective in the third. The sole cost-effectiveness analysis found AI-assisted surveillance not cost-effective over a 2-year horizon. Conclusions: AI achieves dermatologist-level diagnostic accuracy in controlled settings; however, real-world evidence, algorithmic equity across skin phototypes, and health economic viability remain critical unresolved challenges. Prospective validation, mandatory demographic subgroup reporting, and cost-effectiveness modeling are essential prerequisites for safe and equitable clinical implementation.<\/jats:p>","DOI":"10.3390\/diagnostics16172797","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:05:26Z","timestamp":1788224726000},"page":"2797","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Evolving Role of Artificial Intelligence in Dermatology: A Meta-Analysis of Diagnostic Performance, Clinical Applications, and Implementation Challenges (2003\u20132025)"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2187-289X","authenticated-orcid":false,"given":"Nina","family":"Ivanovic","sequence":"first","affiliation":[{"name":"Department of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Doctoral School of Medicine \u201cVictor Babes\u201d, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Research Center for Ethics in Human Genetic Identification (EtIGen), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7114-5226","authenticated-orcid":false,"given":"Marius Florentin","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Forensic Pathology, Faculty of Medicine, \u201cOvidius\u201d University, Aleea Universitatii Nr 1, 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Olivia","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9681-8289","authenticated-orcid":false,"given":"Nicolae Ciprian","family":"Pilut","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0776-0809","authenticated-orcid":false,"given":"Roxana Manuela","family":"Fericean","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Crainic","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Doctoral School of Medicine \u201cVictor Babes\u201d, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-4381","authenticated-orcid":false,"given":"Andreea Nelson","family":"Twakor","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Sf. Apostol Andrei\u201d Emergency County Hospital, 145 Tomis Blvd., 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8837-1558","authenticated-orcid":false,"given":"Daniela Vasilica","family":"Serban","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Doctoral School of Medicine \u201cVictor Babes\u201d, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Center for the Morphologic Study of the Skin (MORPHODERM), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kersztin Lorett","family":"Csiki","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine \u201cVictor Babes\u201d, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Research Center for Ethics in Human Genetic Identification (EtIGen), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1790-8130","authenticated-orcid":false,"given":"Raluca","family":"Dumache","sequence":"additional","affiliation":[{"name":"Research Center for Ethics in Human Genetic Identification (EtIGen), \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Department of Forensic Medicine, Bioethics, Medical Ethics and Medical Law, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1038\/jid.2013.446","article-title":"The global burden of skin disease in 2010: An analysis of the prevalence and impact of skin conditions","volume":"134","author":"Hay","year":"2014","journal-title":"J. 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