专为皮肤科设计的AI助手，自动优化模型并生成医生级诊断解释。

Our work introduces the DermETAS-SNA LLM Assistant that integrates Dermatology-focused Evolutionary Transformer Architecture Search with StackNet Augmented LLM. The assistant dynamically learns skin-disease classifiers and provides medically informed descriptions to facilitate clinician-patient interpretation. Contributions include: (1) Developed an ETAS framework on the SKINCON dataset to optimize a Vision Transformer (ViT) tailored for dermatological feature representation and then fine-tuned binary classifiers for each of the 23 skin disease categories in the DermNet dataset to enhance classification performance; (2) Designed a StackNet architecture that integrates multiple fine-tuned binary ViT classifiers to enhance predictive robustness and mitigate class imbalance issues; (3) Implemented a RAG pipeline, termed Diagnostic Explanation and Retrieval Model for Dermatology, which harnesses the capabilities of the Google Gemini 2.5 Pro LLM architecture to generate personalized, contextually informed diagnostic descriptions and explanations for patients, leveraging a repository of verified dermatological materials; (4) Performed extensive experimental evaluations on 23 skin disease categories to demonstrate performance increase, achieving an overall F1-score of 56.30% that surpasses SkinGPT-4 (48.51%) by a considerable margin, representing a performance increase of 16.06%; (5) Conducted a domain-expert evaluation, with eight licensed medical doctors, of the clinical responses generated by our AI assistant for seven dermatological conditions. Our results show a 92% agreement rate with the assessments provided by our AI assistant (6) Created a proof-of-concept prototype that fully integrates our DermETAS-SNA LLM into our AI assistant to demonstrate its practical feasibility for real-world clinical and educational applications.