Skin Type Determination Using Image Artificial Intelligence
SPAI
Skin Pigment Type, Phototype and Photodamage Determination Using Image Analyses Powered by Artificial Intelligence - SPAI Study
3 other identifiers
observational
1,500
9 countries
11
Brief Summary
Skin color, how easily a person burns or tans in the sun (skin phototype), and the amount of chronic sun damage in the skin are important factors in skin health. These characteristics influence a person's risk of skin cancer, how skin diseases appear, how well treatments work, and how accurately doctors and artificial intelligence (AI) systems can diagnose skin conditions. However, current methods for classifying these characteristics are often imprecise and rely heavily on subjective assessments. As a result, both healthcare professionals and patients may incorrectly classify skin type, which can lead to inaccurate risk assessments and less personalized care. This study aims to develop and validate AI algorithms that can accurately classify skin pigmentation, skin phototype, and accumulated sun damage using photographs of the skin. Unlike existing approaches, the study combines several different methods to create a more objective "ground truth" for training the AI. These methods include skin color measurements using spectrophotometry or colorimetry, assessments using the Monk Skin Tone Scale, questionnaires about sun sensitivity, and clinical evaluations by trained observers. By combining these data sources, the researchers hope to create a more reliable and scientifically robust classification system. The study will recruit adults aged 18 years and older from several countries, including countries from all continents. Participants will complete a questionnaire about their skin, propensity to burn and sun exposure history. Researchers will then take standardized close-up and dermoscopic images of the skin on the arm and forearm, measure skin pigmentation using objective instruments when available, and assess skin phototype and sun damage. No invasive procedures will be performed, and no personally identifiable information will be collected. The collected images and measurements will be used to train deep learning AI models. The researchers aim to develop algorithms that can classify skin pigmentation with at least 85% accuracy, skin phototype with at least 75% accuracy, and sun damage with at least 80% accuracy compared with the combined reference assessments. The algorithms will then be tested in independent datasets, including large dermatology image databases from Sweden, to evaluate how well they perform in different populations. The study has several potential benefits. More accurate classification of skin characteristics could improve personalized skin cancer risk assessments and allow prevention advice to be tailored to individual needs. This may help identify people who would benefit from closer surveillance and stronger sun protection recommendations while avoiding unnecessary restrictions for people at lower risk. Improved classification could also enhance the diagnosis and management of inflammatory skin diseases and skin cancers, which can appear differently in people with different skin tones. An additional goal is to address known biases in dermatology AI systems, which often perform less accurately in individuals with darker skin. By including participants with a wide range of skin tones and backgrounds, the researchers aim to contribute to the benchmarking of AI-driven medical devices wich hopefully can result in the development of fairer and more equitable AI tools. The study involves minimal risk. Only photographs of the arm and forearm will be taken, and researchers will avoid capturing tattoos, prominent scars, or other identifying features. All data will be stored securely and only accessible to authorized researchers. The potential benefits of improving skin disease diagnosis, skin cancer prevention, and fairness in medical AI are considered to outweigh the small privacy risks associated with participation.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for all trials
Started Apr 2025
Typical duration for all trials
11 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
April 28, 2025
CompletedFirst Submitted
Initial submission to the registry
June 15, 2026
CompletedFirst Posted
Study publicly available on registry
August 14, 2026
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 31, 2027
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 31, 2028
August 14, 2026
June 1, 2026
2.7 years
June 15, 2026
August 10, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (4)
Agreement between AI-derived skin pigmentation (tone) classification and objective skin pigmentation measured by colorimetry/ spectrophotometry (Individual Typology Angle, ITA)
Skin pigmentation will be measured objectively using spectrophotometry/ colorimetry and summarized as the Individual Typology Angle (ITA). AI-derived skin pigmentation classification will be compared with ITA values using correlation and agreement analyses. ITA is considered the primary reference standard for objective assessment of skin pigmentation in the interpretation of AI performance.
At completion of model development and testing (approximately 2029).
Accuracy of AI-based skin phototype classification
Accuracy of the deep learning algorithm in classifying skin phototype from clinical and dermoscopic images compared with the reference standard based on the validated Fitzpatrick skin phototype assessment (consisting of 6 categories).
At completion of model development and testing (approximately 2029).
Agreement between AI-derived skin pigmentation (tone) classification and clinician-assessed Monk Skin Tone Scale category
Skin pigmentation will be assessed visually by trained investigators using the Monk Skin Tone Scale (categories 1 (fair) to 10 (dark)). AI-derived classifications will be compared with clinician-assigned Monk categories using agreement and correlation analyses. The Monk Skin Tone Scale represents the principal visual reference standard for skin tone classification.
At completion of model development and testing (approximately 2029).
Agreement between AI-derived photodamage classification and the Clinical Photonumeric Scale for Photodamage Assessment
Photodamage will be assessed using the validated Clinical Photonumeric Scale (0-3 for 3 defined pigmentation categories) for Photodamage Assessment. AI-derived photodamage classifications will be compared with the photonumeric scale scores using agreement and correlation analyses. This outcome evaluates the agreement between AI-derived classifications and a validated photonumeric clinical assessment of photodamage.
At completion of model development and testing (approximately 2029).
Secondary Outcomes (4)
Agreement between AI-derived facial photodamage classification and the Glogau Photoaging Scale
At completion of model development and testing (approximately 2029).
Agreement between AI-derived skin pigmentation classification and participant self-reported skin tone
At completion of model development and testing (approximately 2029).
Agreement between AI-derived skin pigmentation classification and observer-reported skin tone
At completion of AI model (approximately 2029)
Agreement between AI-derived forearm photodamage classification and the Forearm Skin Photoaging Scale
At completion of model development and testing (approximately 2029).
Study Arms (1)
Participants undergoing skin imaging and skin characteristic assessment
Adults aged 18 years and older recruited at participating study sites who undergo standardized clinical and dermoscopic skin imaging, skin pigmentation assessment, skin phototype assessment, photodamage assessment, and questionnaire completion. Data collected from participants will be used to develop and validate artificial intelligence algorithms for classification of skin pigmentation, skin phototype, and photodamage.
Interventions
Participants undergo standardized clinical and dermoscopic skin imaging, skin pigmentation measurements, skin phototype assessments, photodamage assessments, and completion of questionnaires. Data are collected for the development and validation of artificial intelligence algorithms for classification of skin pigmentation, phototype, and photodamage.
Eligibility Criteria
Adults aged 18 years and older will be recruited from dermatology clinics, hospital waiting areas, universities, and other public settings at participating study sites (at present 11 but more are being recruited). The study aims to include individuals representing a broad range of skin pigmentation levels, skin phototypes, and degrees of photodamage. Participants will undergo non-invasive skin imaging, skin characteristic assessments, and questionnaire-based data collection to support the development and validation of artificial intelligence algorithms for classification of skin pigmentation, phototype, and photodamage.
You may qualify if:
- Aged 18 years or older
- Able and willing to provide informed consent (oral or written, according to local regulations)
- Willing to complete the study questionnaire
- Willing to undergo non-invasive skin imaging and skin characteristic assessments of predefined sites on the upper arm and forearm
You may not qualify if:
- Younger than 18 years of age
- Unable to provide informed consent
- Unable to complete study procedures
- Tattoos, prominent scars, wounds, skin lesions, dressings, or other identifiable features at the predefined imaging sites that may interfere with image acquisition, assessment quality, or participant anonymity
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Region Skanelead
- Sahlgrenska University Hospitalcollaborator
- Odense University Hospitalcollaborator
- Hospital Universitario 12 de Octubrecollaborator
- Queen Elizabeth Central Hospital, Blantyre, Malawicollaborator
- University of Chilecollaborator
- Universidad de los Andes, Chilecollaborator
- Mahidol Universitycollaborator
- Monash Universitycollaborator
- The University of Queenslandcollaborator
- Erasmus University Rotterdamcollaborator
- Xiangya Hospital of Central South Universitycollaborator
- University of Colombocollaborator
Study Sites (11)
Hospital de Clínicas de Porto Alegre
Porto Alegre, Brazil
Clinica Universidad de los Andes
Santiago, Chile
Hospital Clínico Universidad de Chile
Santiago, Chile
Xiangya Hospital, Central South University
Changsha, China
Department of Dermatology, Odense University Hospital
Odense, Denmark
Queen Elisabeth Central Hospital
Blantyre, Malawi
Department of Dermatology, Hospital Universitario 12 de Octubre
Madrid, Spain
University of Colombo
Colombo, Sri Lanka
Department of Dermatology Lund, Skåne University Hospital
Lund, Skåne County, 22185, Sweden
Department of Dermatology, Sahlgrenska University Hospital
Gothenburg, Västra Götaland County, Sweden
Siriraj Hospital, Mahidol University
Bangkok, Thailand
Related Publications (18)
Liu X, Sangers TE, Nijsten T, Kayser M, Pardo LM, Wolvius EB, Roshchupkin GV, Wakkee M. Predicting skin cancer risk from facial images with an explainable artificial intelligence (XAI) based approach: a proof-of-concept study. EClinicalMedicine. 2024 Mar 19;71:102550. doi: 10.1016/j.eclinm.2024.102550. eCollection 2024 May.
PMID: 38545426BACKGROUNDHaggenmuller S, Maron RC, Hekler A, Utikal JS, Barata C, Barnhill RL, Beltraminelli H, Berking C, Betz-Stablein B, Blum A, Braun SA, Carr R, Combalia M, Fernandez-Figueras MT, Ferrara G, Fraitag S, French LE, Gellrich FF, Ghoreschi K, Goebeler M, Guitera P, Haenssle HA, Haferkamp S, Heinzerling L, Heppt MV, Hilke FJ, Hobelsberger S, Krahl D, Kutzner H, Lallas A, Liopyris K, Llamas-Velasco M, Malvehy J, Meier F, Muller CSL, Navarini AA, Navarrete-Dechent C, Perasole A, Poch G, Podlipnik S, Requena L, Rotemberg VM, Saggini A, Sangueza OP, Santonja C, Schadendorf D, Schilling B, Schlaak M, Schlager JG, Sergon M, Sondermann W, Soyer HP, Starz H, Stolz W, Vale E, Weyers W, Zink A, Krieghoff-Henning E, Kather JN, von Kalle C, Lipka DB, Frohling S, Hauschild A, Kittler H, Brinker TJ. Skin cancer classification via convolutional neural networks: systematic review of studies involving human experts. Eur J Cancer. 2021 Oct;156:202-216. doi: 10.1016/j.ejca.2021.06.049. Epub 2021 Sep 8.
PMID: 34509059BACKGROUNDDadzie OE, Sturm RA, Fajuyigbe D, Petit A, Jablonski NG. The Eumelanin Human Skin Colour Scale: a proof-of-concept study. Br J Dermatol. 2022 Jul;187(1):99-104. doi: 10.1111/bjd.21277. Epub 2022 May 8.
PMID: 35349165BACKGROUNDDaneshjou R, Barata C, Betz-Stablein B, Celebi ME, Codella N, Combalia M, Guitera P, Gutman D, Halpern A, Helba B, Kittler H, Kose K, Liopyris K, Malvehy J, Seog HS, Soyer HP, Tkaczyk ER, Tschandl P, Rotemberg V. Checklist for Evaluation of Image-Based Artificial Intelligence Reports in Dermatology: CLEAR Derm Consensus Guidelines From the International Skin Imaging Collaboration Artificial Intelligence Working Group. JAMA Dermatol. 2022 Jan 1;158(1):90-96. doi: 10.1001/jamadermatol.2021.4915.
PMID: 34851366BACKGROUNDDaneshjou R, Smith MP, Sun MD, Rotemberg V, Zou J. Lack of Transparency and Potential Bias in Artificial Intelligence Data Sets and Algorithms: A Scoping Review. JAMA Dermatol. 2021 Nov 1;157(11):1362-1369. doi: 10.1001/jamadermatol.2021.3129.
PMID: 34550305BACKGROUNDSteele L, Tan XL, Olabi B, Gao JM, Tanaka RJ, Williams HC. Determining the clinical applicability of machine learning models through assessment of reporting across skin phototypes and rarer skin cancer types: A systematic review. J Eur Acad Dermatol Venereol. 2023 Apr;37(4):657-665. doi: 10.1111/jdv.18814. Epub 2023 Jan 2.
PMID: 36514990BACKGROUNDWilliams JR, Frey C, Cohen GF. Cutaneous Sarcoidosis in Skin of Color. J Drugs Dermatol. 2023 Jul 1;22(7):695-697. doi: 10.36849/JDD.7008.
PMID: 37410043BACKGROUNDHogue L, Harvey VM. Basal Cell Carcinoma, Squamous Cell Carcinoma, and Cutaneous Melanoma in Skin of Color Patients. Dermatol Clin. 2019 Oct;37(4):519-526. doi: 10.1016/j.det.2019.05.009.
PMID: 31466591BACKGROUNDGuitera P, Menzies SW, Argenziano G, Longo C, Losi A, Drummond M, Scolyer RA, Pellacani G. Dermoscopy and in vivo confocal microscopy are complementary techniques for diagnosis of difficult amelanotic and light-coloured skin lesions. Br J Dermatol. 2016 Dec;175(6):1311-1319. doi: 10.1111/bjd.14749. Epub 2016 Oct 12.
PMID: 27177158BACKGROUNDEbede T, Papier A. Disparities in dermatology educational resources. J Am Acad Dermatol. 2006 Oct;55(4):687-90. doi: 10.1016/j.jaad.2005.10.068.
PMID: 17010750BACKGROUNDLindqvist PG, Landin-Olsson M, Olsson H. Low sun exposure habits is associated with a dose-dependent increased risk of hypertension: a report from the large MISS cohort. Photochem Photobiol Sci. 2021 Feb;20(2):285-292. doi: 10.1007/s43630-021-00017-x. Epub 2021 Feb 18.
PMID: 33721253BACKGROUNDTaylor SC, Arsonnaud S, Czernielewski J; Hyperpigmentation Scale Study Group. The Taylor Hyperpigmentation Scale: a new visual assessment tool for the evaluation of skin color and pigmentation. Cutis. 2005 Oct;76(4):270-4.
PMID: 16315565BACKGROUNDEnglish DR, Armstrong BK, Kricker A, Winter MG, Heenan PJ, Randell PL. Demographic characteristics, pigmentary and cutaneous risk factors for squamous cell carcinoma of the skin: a case-control study. Int J Cancer. 1998 May 29;76(5):628-34. doi: 10.1002/(sici)1097-0215(19980529)76:53.0.co;2-s.
PMID: 9610717BACKGROUNDTan K, Lo SN, Cust AE, Wolfe R, Mar V. Sensitivity of two Australian melanoma risk tools to identify high-risk individuals among people presenting with their first primary melanoma. Australas J Dermatol. 2022 Aug;63(3):352-358. doi: 10.1111/ajd.13841. Epub 2022 May 6.
PMID: 35522684BACKGROUNDVuong K, Armstrong BK, Drummond M, Hopper JL, Barrett JH, Davies JR, Bishop DT, Newton-Bishop J, Aitken JF, Giles GG, Schmid H, Jenkins MA, Mann GJ, McGeechan K, Cust AE. Development and external validation study of a melanoma risk prediction model incorporating clinically assessed naevi and solar lentigines. Br J Dermatol. 2020 May;182(5):1262-1268. doi: 10.1111/bjd.18411. Epub 2019 Sep 22.
PMID: 31378928BACKGROUNDOkoji UK, Taylor SC, Lipoff JB. Equity in skin typing: why it is time to replace the Fitzpatrick scale. Br J Dermatol. 2021 Jul;185(1):198-199. doi: 10.1111/bjd.19932. Epub 2021 Apr 22. No abstract available.
PMID: 33666245BACKGROUNDLim SS, Mohammad TF, Kohli I, Hamzavi I, Rodrigues M. Optimisation of skin phototype classification. Pigment Cell Melanoma Res. 2023 Nov;36(6):468-471. doi: 10.1111/pcmr.13110. Epub 2023 Aug 7.
PMID: 37550876BACKGROUNDBarsh GS. What controls variation in human skin color? PLoS Biol. 2003 Oct;1(1):E27. doi: 10.1371/journal.pbio.0000027. Epub 2003 Oct 13.
PMID: 14551921BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- observational
- Observational Model
- OTHER
- Time Perspective
- CROSS SECTIONAL
- Target Duration
- 1 Day
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
June 15, 2026
First Posted
August 14, 2026
Study Start
April 28, 2025
Primary Completion (Estimated)
December 31, 2027
Study Completion (Estimated)
December 31, 2028
Last Updated
August 14, 2026
Record last verified: 2026-06
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, ICF
- Time Frame
- IPD will be shared when the study is completed, 2029-2030.
- Access Criteria
- No limitations. Images, measurement data, basic participant characteristics.
We plan to publish the image dataset with key measurement data publicly after the completion of the study.