The Role of AI-Generated Clinical Image Descriptions in Enhancing Teledermatology Diagnosis: A Cross-Sectional Exploratory Study

<b>Background/Objectives:</b> AI models such as ChatGPT-4 have shown strong performance in dermatology; however, the diagnostic value of AI-generated clinical image descriptions remains underexplored. This study assesses whether ChatGPT-4's image descriptions can support accurate dermatologic diagnosis and evaluates their potential integration into the Electronic Medical Record (EMR) system. <b>Materials & Methods:</b> In this Exploratory cross-sectional study, we analyzed images and descriptions from teledermatology consultations conducted between December 2023 and February 2024. ChatGPT-4 generated clinical descriptions for each image, which two senior dermatologists then used to formulate differential diagnoses. Diagnoses based on ChatGPT-4's output were compared to those derived from the original clinical notes written by teledermatologists. Concordance was categorized as Top1 (exact match), Top3 (correct within top three), Partial, or No match. <b>Results:</b> The study included 154 image descriptions from 67 male and 87 female patients, aged 0 to 93 years. ChatGPT-4 descriptions averaged 74.3 ± 33.1 words, compared to 7.9 ± 3.0 words for teledermatologists. At least one of the two dermatologists achieved a Top 3 concordance rate of 82.5% using ChatGPT-4's descriptions and 85.3% with teledermatologist descriptions. <b>Conclusions:</b> Preliminary findings highlight the potential integration of ChatGPT-4-generated descriptions into EMRs to enhance documentation. Although AI descriptions were longer, they did not enhance diagnostic accuracy, and expert validation remained essential.