Skin Neglected Tropical Diseases (NTDs) impose severe health and socioeconomic burdens in impoverished tropical communities. Yet, advancements in AI-driven diagnostic support are hindered by data scarcity, particularly for underrepresented populations and rare manifestations of NTDs. Existing dermatological datasets often lack the demographic and disease spectrum crucial for developing reliable recognition models of NTDs. To address this, we introduce eSkinHealth, a novel dermatological dataset collected on-site in Côte d'Ivoire and Ghana. Specifically, eSkinHealth contains 5,623 images from 1,639 cases and encompasses 47 skin diseases, focusing uniquely on skin NTDs and rare conditions among West African populations. We further propose an AI-expert collaboration paradigm to implement foundation language and segmentation models for efficient generation of multimodal annotations, under dermatologists' guidance. In addition to patient metadata and diagnosis labels, eSkinHealth also includes semantic lesion masks, instance-specific visual captions, and clinical concepts. Overall, our work provides a valuable new resource and a scalable annotation framework, aiming to catalyze the development of more equitable, accurate, and interpretable AI tools for global dermatology.

Current AI-assisted skin image diagnosis has achieved dermatologist-level performance in classifying skin cancer, driven by rapid advancements in deep learning architectures. However, unlike traditional vision tasks, skin images in general present unique challenges due to the limited availability of well-annotated datasets, complex variations in conditions, and the necessity for detailed interpretations to ensure patient safety. Previous segmentation methods have sought to reduce image noise and enhance diagnostic performance, but these techniques require fine-grained, pixel-level ground truth masks for training. In contrast, with the rise of foundation models, the Segment Anything Model (SAM) has been introduced to facilitate promptable segmentation, enabling the automation of the segmentation process with simple yet effective prompts. Efforts applying SAM pre-dominantly focus on dermatoscopy images, which present more easily identifiable lesion boundaries than clinical photos taken with smartphones. This limitation constrains the practicality of these approaches to real-world applications. To overcome the challenges posed by noisy clinical photos acquired via non-standardized protocols and to improve diagnostic accessibility, we propose a novel Cross-Attentive Fusion framework for interpretable skin lesion diagnosis. Our method leverages SAM to generate visual concepts for skin diseases using prompts, integrating local visual concepts with global image features to enhance model performance. Extensive evaluation on two skin disease datasets demonstrates our proposed method's effectiveness on lesion diagnosis and interpretability.