# CG-HAF: An Interpretable Global-Local Lesion-Burden Fusion Framework for Ordinal Acne Severity Grading in Agentic Skincare Support

arXiv: https://arxiv.org/abs/2609.31326 · HTML: https://mlsanity.com/paper/2609.31326/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 5 of its 37 references that are in the map.
- First posted on arXiv 25 Sep 2026.

## Builds on (most cited first, 5 of 5)

- [On Calibration of Modern Neural Networks](https://mlsanity.com/paper/1706.04599/) (2017)
- [ConvNeXt V2: Co-designing and Scaling ConvNets with Masked Autoencoders](https://mlsanity.com/paper/2301.00808/) (2023)
- [YOLOv12: Attention-Centric Real-Time Object Detectors](https://mlsanity.com/paper/2502.12524/) (2025)
- [ACNet: Mask-Aware Attention with Dynamic Context Enhancement for Robust Acne Detection](https://mlsanity.com/paper/2105.14891/) (2021)
- [Improving Acne Image Grading with Label Distribution Smoothing](https://mlsanity.com/paper/2403.00268/) (2024)

## Abstract (arXiv)

Ordinal acne severity grading requires distinguishing visually similar neighboring grades while jointly weighing holistic facial appearance and localized lesion burden - evidence that most existing approaches collapse into a single opaque representation. We introduce CG-HAF, a global-local fusion framework that instead keeps this evidence explicit: averaged holistic severity probabilities from independently trained classifiers are combined with structured lesion-burden descriptors from an object detector (lesion count, detection confidence, lesion area) into a compact representation, from which a lightweight, interpretable classifier produces the final grade. On a widely used benchmark, this fusion yields a clear, statistically supported improvement over global-evidence-only baselines, with the largest gains on the most severe cases. Testing on an independent dataset with a different grading standard shows that strong within-dataset performance does not transfer automatically, and a follow-up diagnostic attributes much of this gap to mismatched grading criteria rather than detection failure alone. These findings support interpretable global-local fusion as an effective strategy for ordinal acne grading while highlighting criterion alignment as key to cross-dataset portability, with a further illustration of how the resulting severity signal can support transparent, non-diagnostic decision-making in skincare applications.