Generative Adversarial Networks in Dermatology: A Narrative Review of Current Applications, Challenges, and Future Perspectives.

Generative Adversarial Networks (GANs) have emerged as powerful tools in artificial intelligence (AI) with growing relevance in medical imaging. In dermatology, GANs are revolutionizing image analysis, enabling synthetic image generation, data augmentation, color standardization, and improved diagnostic model training. This narrative review explores the landscape of GAN applications in dermatology, systematically analyzing 27 key studies and identifying 11 main clinical use cases. These range from the synthesis of under-represented skin phenotypes to segmentation, denoising, and super-resolution imaging. The review also examines the commercial implementations of GAN-based solutions relevant to practicing dermatologists. We present a comparative summary of GAN architectures, including DCGAN, cGAN, StyleGAN, CycleGAN, and advanced hybrids. We analyze technical metrics used to evaluate performance-such as Fréchet Inception Distance (FID), SSIM, Inception Score, and Dice Coefficient-and discuss challenges like data imbalance, overfitting, and the lack of clinical validation. Additionally, we review ethical concerns and regulatory limitations. Our findings highlight the transformative potential of GANs in dermatology while emphasizing the need for standardized protocols and rigorous validation. While early results are promising, few models have yet reached real-world clinical integration. The democratization of AI tools and open-access datasets are pivotal to ensure equitable dermatologic care across diverse populations. This review serves as a comprehensive resource for dermatologists, researchers, and developers interested in applying GANs in dermatological practice and research. Future directions include multimodal integration, clinical trials, and explainable GANs to facilitate adoption in daily clinical workflows.