Abstract
Accurate diagnosis of skin diseases remains a significant challenge due to the complex and diverse visual features present in dermatoscopic images, often compounded by a lack of interpretability in existing purely visual diagnostic models. To address these limitations, this study introduces VL-MedGuide (Visual-Linguistic Medical Guide), a novel framework leveraging the powerful multi-modal understanding and reasoning capabilities of Visual-Language Large Models (LVLMs) for intelligent and inherently interpretable auxiliary diagnosis of skin conditions. VL-MedGuide operates in two interconnected stages: a Multi-modal Concept Perception Module, which identifies and linguistically describes dermatologically relevant visual features through sophisticated prompt engineering, and an Explainable Disease Reasoning Module, which integrates these concepts with raw visual information via Chain-of-Thought prompting to provide precise disease diagnoses alongside transparent rationales. Comprehensiv