用生成模型解释皮肤癌诊断不确定，让AI的犹豫变成可看的依据。

Melanoma is a highly aggressive skin cancer, making early and accurate diagnosis critical. While deep learning excels in skin lesion classification, standard ``black-box" models struggle to explain diagnostic uncertainty, limiting clinical trust. This work introduces a hybrid framework combining a class-aware adversarial Variational Autoencoder and an XGBoost classifier, transcending simple binary classification by leveraging a generative latent space for interpretable decision support. Guided by adversarial training, the model learns the visual characteristics of skin lesions and projects them into a continuous latent space, ensuring that similar images are grouped closely together. Trained on this latent space, the XGBoost classifier achieves a robust AUC of 0.868, competing closely with state-of-the-art models. For borderline cases, the framework enables clinicians to leverage the latent topology through Content-Based Image Retrieval. This provides a dual benefit: it allows the clinician to visually compare an ambiguous lesion against biopsy-confirmed precedents and acts as an early warning sign since a borderline classification can indicate that a lesion shares features of both nevi and melanomas, potentially requiring close monitoring. Our approach translates algorithmic hesitation into transparent, evidence-based visual support, bridging the gap between predictive performance and clinical trust.