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Skinpendium

Device Information

Technical and regulatory information about the Skinpendium Clinical Decision Support System.

Rx Only — Prescription Device

Federal law restricts this device to sale by or on the order of a physician (21 CFR 801.109). Skinpendium is investigational, not FDA-cleared.

Device Classification

Device Name
Skinpendium Clinical Decision Support System
Proposed Classification
Class II
Product Code
QZS
Regulation Number
21 CFR 878.1830
Generic Name
Software-aided adjunctive diagnostic device for use by physicians on lesions suspicious for skin cancer

Intended Use Statement

The Skinpendium device is indicated for use to evaluate dermoscopic images of skin lesions suggestive of melanoma, basal cell carcinoma, and/or squamous cell carcinoma in patients aged 40 and above to assist in the decision of biopsy or referral to a dermatologist.

The Skinpendium device analyzes and gives a probability of malignancy, likely classification of the lesion, and retrieves similar cases from a validated database of histopathology-confirmed/dermatologic-consensus lesions that the model was trained on to support clinical decision-making.

The device should be used in conjunction with the totality of clinically relevant information from the clinical assessment by physicians who are not dermatologists. The device should be used on lesions already assessed as suspicious for skin cancer and not as a screening tool. The device should not be used as the sole diagnostic criterion nor to confirm clinical diagnosis of skin cancer.

System Architecture

Skinpendium is deployed as a three-tier system: client applications, a cloud API, and the AI engine.

Tier 1

Client Applications

Mobile app (iOS and Android) for dermoscopic image capture, offline-first sync, and patient consent. An EMR plugin pulls Patient demographics and writes DiagnosticReport (AI result) plus ServiceRequest / Task (biopsy referral and follow-up) back to the EHR with server-side audit logging for every writeback.

Tier 2

Cloud API

FastAPI REST server handles inference requests and data synchronization. API key authentication (SHA-256 hashed, per-organization), HIPAA-compliant audit logging, rate limiting, and request validation. TLS 1.2+ for all communication.

Tier 3

AI Engine

A frozen vision foundation model extracts an embedding from each image. A binary malignancy head and a lesion-type classifier produce probabilities calibrated by isotonic regression, and a similarity index retrieves comparable confirmed cases.

Supported EHRs

Epic
Oracle Health (Cerner)
SMART Health IT sandbox (development)

AI Pipeline

Each dermoscopic image is processed through a six-stage pipeline.

StageComponentOutput
1. Feature extractionVision foundation model (frozen)Image embedding
2. Binary classificationLinear classification headMalignant/benign probability
3. Differential diagnosisLesion-type classifierProbability for each lesion type
4. CalibrationIsotonic regressionCalibrated probabilities
5. Similar case retrievalSimilarity indexMost similar confirmed cases
6. Clinical outputAggregation layerBiopsy/referral recommendation

Technical Specifications

Model Architecture

Backbone
Vision foundation model (frozen)
Outputs
Malignancy probability, lesion type
Calibration
Isotonic regression
Evidence
Similar confirmed cases

Security & Compliance

  • Fernet/AES-256 encryption at rest
  • TLS 1.2+ for all API communication
  • HIPAA Safe Harbor de-identification
  • No PHI stored in audit logs
  • API key authentication (SHA-256 hashed)