# Synthetic Data Generation for Long-Tail Medical Image Classification: A Case Study in Skin Lesions

arXiv: https://arxiv.org/abs/2605.03221 · HTML: https://mlsanity.com/paper/2605.03221/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 28 of its 40 references that are in the map.
- First posted on arXiv 4 May 2026.

## Placed in

- Diffusion models / [Medical imaging and segmentation](https://mlsanity.com/diffusion/medical-imaging-and-segmentation/)

## Builds on (most cited first, 28 of 28)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Photorealistic Text-to-Image Diffusion Models with Deep Language Understanding](https://mlsanity.com/paper/2205.11487/) (2022)
- [Adding Conditional Control to Text-to-Image Diffusion Models](https://mlsanity.com/paper/2302.05543/) (2023)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [DreamBooth: Fine Tuning Text-to-Image Diffusion Models for Subject-Driven Generation](https://mlsanity.com/paper/2208.12242/) (2022)
- [Stable Video Diffusion: Scaling Latent Video Diffusion Models to Large Datasets](https://mlsanity.com/paper/2311.15127/) (2023)
- [Sharpness-Aware Minimization for Efficiently Improving Generalization](https://mlsanity.com/paper/2010.01412/) (2020)
- [Learning Imbalanced Datasets with Label-Distribution-Aware Margin Loss](https://mlsanity.com/paper/1906.07413/) (2019)
- [Decoupling Representation and Classifier for Long-Tailed Recognition](https://mlsanity.com/paper/1910.09217/) (2019)
- [Deep Long-Tailed Learning: A Survey](https://mlsanity.com/paper/2110.04596/) (2021)
- [BBN: Bilateral-Branch Network with Cumulative Learning for Long-Tailed Visual Recognition](https://mlsanity.com/paper/1912.02413/) (2019)
- [Balanced Meta-Softmax for Long-Tailed Visual Recognition](https://mlsanity.com/paper/2007.10740/) (2020)
- [Equalization Loss for Long-Tailed Object Recognition](https://mlsanity.com/paper/2003.05176/) (2020)
- [Disentangling Label Distribution for Long-tailed Visual Recognition](https://mlsanity.com/paper/2012.00321/) (2020)
- [Range Loss for Deep Face Recognition with Long-tail](https://mlsanity.com/paper/1611.08976/) (2016)
- [Label-Imbalanced and Group-Sensitive Classification under Overparameterization](https://mlsanity.com/paper/2103.01550/) (2021)
- [Self Supervision to Distillation for Long-Tailed Visual Recognition](https://mlsanity.com/paper/2109.04075/) (2021)
- [Learning Fast Sample Re-weighting Without Reward Data](https://mlsanity.com/paper/2109.03216/) (2021)
- [Class-Balancing Diffusion Models](https://mlsanity.com/paper/2305.00562/) (2023)
- [Skin Lesion Classification Using Ensembles of Multi-Resolution EfficientNets with Meta Data](https://mlsanity.com/paper/1910.03910/) (2019)
- [CUDA: Curriculum of Data Augmentation for Long-Tailed Recognition](https://mlsanity.com/paper/2302.05499/) (2023)
- [MONICA: Benchmarking on Long-tailed Medical Image Classification](https://mlsanity.com/paper/2410.02010/) (2024)

## Built on by (most cited first, 1 of 1)

- [MedPrune: Topology-Efficient Multimodal Multi-Agent Communication Evolution for Medical VQA Tasks](https://mlsanity.com/paper/2610.06695/) (2026)

## Abstract (arXiv)

Long-tailed class distributions are pervasive in multi-class medical datasets and pose significant challenges for deep learning models which typically underperform on tail classes with limited samples. This limitation is particularly problematic in medical applications, where rare classes often correspond to severe or high-risk diseases and therefore require high diagnostic accuracy. Existing solutions-including specialized architectures, rebalanced loss functions, and handcrafted data augmentation-offer only marginal improvements and struggle to scale due to their limited and largely deterministic variability. To address these challenges, we introduce a diffusion-model-driven synthetic data augmentation pipeline tailored for medical long-tailed classification. Our approach features a novel inpainting diffusion model combined with an Out-of-Distribution (OOD) post-selection mechanism to ensure diverse, realistic, and clinically meaningful synthetic samples. Evaluated on the ISIC2019 skin lesion classification dataset, one of the largest and most imbalanced medical imaging benchmarks, our method yields substantial improvements in overall performance, with particularly pronounced gains on tail classes with more than 28% improvement on the class with the fewest samples. These results demonstrate the effectiveness of diffusion-based augmentation in mitigating long-tail imbalance and enhancing medical classification robustness.