# Towards Trustworthy Dermatology MLLMs: A Benchmark and Multimodal Evaluator for Diagnostic Narratives

arXiv: https://arxiv.org/abs/2511.09195 · HTML: https://mlsanity.com/paper/2511.09195/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 38 of its 65 references that are in the map.
- First posted on arXiv 12 Nov 2025.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 38)

- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Self-Consistency Improves Chain of Thought Reasoning in Language Models](https://mlsanity.com/paper/2203.11171/) (2022)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Large Language Models are Zero-Shot Reasoners](https://mlsanity.com/paper/2205.11916/) (2022)
- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [LLaVA-OneVision: Easy Visual Task Transfer](https://mlsanity.com/paper/2408.03326/) (2024)
- [MMMU: A Massive Multi-discipline Multimodal Understanding and Reasoning Benchmark for Expert AGI](https://mlsanity.com/paper/2311.16502/) (2023)
- [InternVL3: Exploring Advanced Training and Test-Time Recipes for Open-Source Multimodal Models](https://mlsanity.com/paper/2504.10479/) (2025)
- [A Survey on LLM-as-a-Judge](https://mlsanity.com/paper/2411.15594/) (2024)
- [Least-to-Most Prompting Enables Complex Reasoning in Large Language Models](https://mlsanity.com/paper/2205.10625/) (2022)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [MM-Vet: Evaluating Large Multimodal Models for Integrated Capabilities](https://mlsanity.com/paper/2308.02490/) (2023)
- [Automatic Chain of Thought Prompting in Large Language Models](https://mlsanity.com/paper/2210.03493/) (2022)
- [Vision-R1: Incentivizing Reasoning Capability in Multimodal Large Language Models](https://mlsanity.com/paper/2503.06749/) (2025)
- [Prometheus: Inducing Fine-grained Evaluation Capability in Language Models](https://mlsanity.com/paper/2310.08491/) (2023)
- [LLaVA-CoT: Let Vision Language Models Reason Step-by-Step](https://mlsanity.com/paper/2411.10440/) (2024)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [Towards Generalist Biomedical AI](https://mlsanity.com/paper/2307.14334/) (2023)
- [Judging the Judges: A Systematic Study of Position Bias in LLM-as-a-Judge](https://mlsanity.com/paper/2406.07791/) (2024)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)
- [LLaVA-Critic: Learning to Evaluate Multimodal Models](https://mlsanity.com/paper/2410.02712/) (2024)
- [MedReason: Eliciting Factual Medical Reasoning Steps in LLMs via Knowledge Graphs](https://mlsanity.com/paper/2504.00993/) (2025)
- [Limitations of the LLM-as-a-Judge Approach for Evaluating LLM Outputs in Expert Knowledge Tasks](https://mlsanity.com/paper/2410.20266/) (2024)
- [Optimizing the Factual Correctness of a Summary: A Study of Summarizing Radiology Reports](https://mlsanity.com/paper/1911.02541/) (2019)
- [Improving the Factual Correctness of Radiology Report Generation with Semantic Rewards](https://mlsanity.com/paper/2210.12186/) (2022)
- [Annotation-efficient deep learning for automatic medical image segmentation](https://mlsanity.com/paper/2012.04885/) (2020)
- [A Multimodal Vision Foundation Model for Clinical Dermatology](https://mlsanity.com/paper/2410.15038/) (2024)

## Built on by (most cited first, 2 of 2)

- [Trustworthy and Fair SkinGPT-R1 for Democratizing Dermatological Reasoning across Diverse Ethnicities](https://mlsanity.com/paper/2511.15242/) (2025)
- [DermoGPT: Open Weights and Open Data for Morphology-Grounded Dermatological Reasoning MLLMs](https://mlsanity.com/paper/2601.01868/) (2026)

## Abstract (arXiv)

Multimodal large language models (LLMs) are increasingly used to generate dermatology diagnostic narratives directly from images. However, reliable evaluation remains the primary bottleneck for responsible clinical deployment. We introduce a novel evaluation framework that combines DermBench, a meticulously curated benchmark, with DermEval, a robust automatic evaluator, to enable clinically meaningful, reproducible, and scalable assessment. We build DermBench, which pairs 4,000 real-world dermatology images with expert-certified diagnostic narratives and uses an LLM-based judge to score candidate narratives across clinically grounded dimensions, enabling consistent and comprehensive evaluation of multimodal models. For individual case assessment, we train DermEval, a reference-free multimodal evaluator. Given an image and a generated narrative, DermEval produces a structured critique along with an overall score and per-dimension ratings. This capability enables fine-grained, per-case analysis, which is critical for identifying model limitations and biases. Experiments on a diverse dataset of 4,500 cases demonstrate that DermBench and DermEval achieve close alignment with expert ratings, with mean deviations of 0.251 and 0.117 (out of 5), respectively, providing reliable measurement of diagnostic ability and trustworthiness across different multimodal LLMs.