Digital Dermatologic Innovation Dominates Conversations at AAD 2026

This content was developed independently and is not endorsed by the American Academy of Dermatology.

Building on insights from last year, experts across sessions at the 2026 American Academy of Dermatology (AAD) Annual Meeting in Denver, Colorado, discussed the benefits and limitations of technology in dermatology, with a particular focus on teledermatology and artificial intelligence (AI).¹

Teledermatology and AI remain hot topics as they continue to evolve, presenting both new opportunities and challenges for the specialty.

Teledermatology Improves Access and Efficiency

Featured again this year, the session “Leveraging Teledermatology to Improve Patient Access to Dermatologist-Level Care” highlighted how teledermatology, through video visits, portal messaging, and electronic consultations (e-consults), can improve efficiency, expand patient access, and provide billable alternatives to in-person care.²

Elizabeth Jones, MD, FAAD, of Thomas Jefferson University Hospitals, encouraged dermatologists to “work smarter, not harder” by using teledermatology to improve efficiency and protect revenue, especially in solo and small physician-led practices facing narrow margins. She outlined several advantages of video visits, including greater convenience and flexible scheduling for patients, as well as the ability for practices to maintain clinic volume during staffing shortages. These visits can also help reduce bottlenecks by allowing providers to alternate between in-person and virtual care, creating more predictable schedules and improving staff satisfaction. Similarly, Jones added that video visits enable clinicians to see appropriate patients the same day, rather than overbooking in-person appointments.

Addressing concerns about visit length and reimbursement, she explained that video visits can be efficient with proper triage, typically lasting about 15 minutes for established patients and 20 for new patients. Reimbursement, Jones added, is generally comparable to in-person evaluation and management services, particularly as telehealth policy support continues.

She ultimately recommended a hybrid care model, noting that video visits are well-suited for acne, common rashes, chronic inflammatory disease follow-up, medication monitoring, and prescription refills. In contrast, suspicious lesions, full skin examinations, and sensitive areas where imaging may be inadequate should be evaluated in person.

Building on this discussion, Lia Gracey Maniar, MD, PhD, FAAD, of Ascension, outlined how teledermatology can also help dermatologists manage increasing inbox volume while creating reimbursement opportunities.

She explained that patient portal messaging has surged, with the trend accelerating following the passage of the Health Information Technology for Economic and Clinical Health Act of 2009 and further expanding during the COVID-19 pandemic. As a result, dermatologists now receive an average of nearly 50 messages per day, many involving photos and clinical decision-making, which can strain their workflow and contribute to burnout.

However, CMS allows clinicians to bill certain portal interactions as e-visits using Current Procedural Terminology (CPT) codes 99421 through 99423. At least 25 major institutions, including UCSF Health, have implemented message billing. Gracey Maniar noted that early data suggest the institution has seen a modest impact, with message volume decreasing by 2% to 3% after implementation.

Another advantage of teledermatology is its ability to reduce informal “curbside” consultations, in which clinicians field questions via text messages, electronic medical record messages, or hallway conversations, according to Sara Harcharik Perkins, MD, FAAD, of Yale School of Medicine.

Although many dermatologists handle multiple curbsides each week, often spending at least 5 minutes per case, these interactions typically generate no compensation or work relative value unit credit. In contrast, e-consults provide a structured, billable alternative that allows dermatologists to offer remote consultative input to primary care providers (PCPs) for both new and established patients.

Harcharik Perkins explained that a typical workflow involves referring clinicians submitting clinical history and images, followed by specialists providing recommendations, rationale, and follow-up guidance. She noted high satisfaction among PCPs, with 70% to 85% of cases managed without requiring an in-person visit.

When in-person care is necessary, Harcharik Perkins highlighted that e-consults improve triage, enabling faster access for urgent cases and more appropriate scheduling overall without reducing traditional referral volumes.

The benefits of e-consults were echoed by John R. Durkin, MD, FAAD, of the University of New Mexico School of Medicine, during the “Reducing Rural Health Disparities in Skin Cancer” session.³ He emphasized that they help keep care local while building PCP capacity, enabling them to become the “derm person” in their communities. They also allow dermatologists to provide guidance in approximately 5 minutes without assuming full ongoing management, an approach Durkin described as particularly valuable in the dermatology deserts of rural America.

“At the end of the day, there are going to be some things that patients need to come to specialized centers for, but the more we can do to improve the referral network, the better,” he concluded.

Cost, Equity Challenges in Teledermatology

At the same time, experts acknowledged teledermatology’s limitations. With video visits, Durkin explained that poor image quality can lead to in-person follow-up, doubling dermatologists’ workload. He added that video visits may also disrupt busy clinic workflows and increase the risk of missed calls or follow-ups.

Durkin also highlighted the hidden time burden associated with patient messaging, administrative tasks, setup, and electronic medical record management. Overall, teledermatology remains constrained by dermatologist availability, with reimbursement generally less favorable than for in-person visits.

Similarly, Gracey Maniar emphasized that patient equity and cost concerns remain key barriers to portal messaging, as some studies have shown reduced portal use among certain populations, including Latinx and Asian individuals, following billing implementation.²

She added that patient out-of-pocket costs remain inconsistent. Some institutions report costs of $14 to $52 for Medicare beneficiaries with minimal costs for privately insured patients, and others report no cost for Medicare beneficiaries but potential charges of $30 to $75 for private plans. This variability, Gracey Maniar said, can make it challenging for patients to provide informed consent.

“In theory, [billing] could potentially reduce the patient portal message load, but it might be a little more modest based on some early data that we're seeing from these institutions…” she said. “On the flip side, there is risk for patient abrasion when trying to bill for things they were used to getting for free, and…the billing policies are a little bit unclear, so it can be hard for patients to give informed consent when they're not really sure how much this is going to cost them.”

Navigating the Opportunities and Challenges of AI in Dermatology

Beyond teledermatology, AI was the other major technological area of focus.⁴ AI has both its advantages and disadvantages within the specialty, as reflected by experts in the session, “The 2026 Debates: Controversies in Dermatology.”

Yevgeniy Semenov, MD, MS, FAAD, of Massachusetts General Hospital, highlighted the benefits of AI within dermatology, reiterating his presenttion during an earlier session, “Bread n’ Butter with a Side of Nutella: Short n’ Sweet, High-Yield Updates on Management of Bread n’ Butter Dermatologic Diseases.”⁵

While AI in dermatology is not new, he noted that advances in computing power and data have rapidly accelerated its capabilities.⁴ Consequently, modern deep learning enables highly accurate image analysis, with studies showing performance that can match or exceed dermatologists in distinguishing benign from malignant lesions.

As a result, AI is being increasingly used as a diagnostic support tool, with evidence showing modest improvements in accuracy when combined with physician judgment. Beyond diagnosis, AI is advancing prognostication and clinical operations. Semenov highlighted that machine learning models analyzing digitized histopathology and clinical data can generate risk scores that may outperform traditional staging and predict both recurrence risk and patterns.

At the same time, AI is already transforming workflows. Ambient documentation tools are reducing time per visit, increasing same-day note completion, and cutting time spent on after-hours charting. He added that additional applications, like AI-assisted scheduling, previsit intake, and tailored patient education, are improving efficiency and patient engagement.

In contrast, Shannon Wongvibulsin, MD, PhD, of the University of California, Los Angeles, highlighted important limitations surrounding AI use in dermatology. She noted that approximately 80% of physicians report using AI, yet most lack formal guidance on its safe, ethical application.

Wongvibulsin emphasized that overreliance on AI may lead to “de-skilling,” or the erosion of existing clinical expertise. Meanwhile, excessive dependence on these tools among trainees can result in “never-skilling,” in which they fail to fully develop foundational clinical skills. Together, these trends raise concerns about how clinicians are integrating AI in practice.

Within the dermatology space, she emphasized ongoing concerns about the quality and transparency of AI tools. Many are built on limited evidence, developed with minimal dermatologist input, and perform less effectively on darker skin tones. In addition, clinicians often lack insight into what data models the tools were trained on, making it difficult to assess how they will perform across diverse patient populations.

On the topic of misinformation, Wongvibulsin explained that deepfakes and AI-generated content can impersonate doctors and other experts, often spreading plausible but false medical information. Although medical chatbots are already widely used, they can be hacked and manipulated to provide harmful recommendations. Similarly, large language models, like ChatGPT or Gemini, may adapt their responses to align with user input, even when incorrect.

Overall, she stressed that although AI holds promise, dermatologists must take steps to ensure its responsible use.

“In conclusion, there is an increasing number of AI tools in dermatology, but education on safe and ethical use of these tools is overall lacking,” she concluded. “AI tools need to be cautiously evaluated prior to use, as numerous unknowns and unintended consequences remain.”

References

1. McCormick B. Technology takes center stage at the 2025 AAD Annual Meeting. AJMC. March 14, 2025. Accessed April 3, 2026. https://www.ajmc.com/view/technology-takes-center-stage-at-the-2025-aad-annual-meeting
2. McCormick B. Teledermatology expands patient access, reimbursement opportunities. AJMC. March 28, 2026. Accessed April 3, 2026. https://www.ajmc.com/view/teledermatology-expands-patient-access-reimbursement-opportunities
3. McCormick B. PCP support, community outreach help close rural dermatology access gaps. AJMC. March 28, 2026. Accessed April 3, 2026. https://www.ajmc.com/view/pcp-support-community-outreach-help-close-rural-dermatology-access-gaps
4. Chu EY, Moshiri A, Polsky D, et al. The 2026 debates: controversies in dermatology. Presented at: 2026 AAD Annual Meeting; March 27-31, 2026; Denver, CO.
5. McCormick B. Emerging therapies, innovations highlight the evolving dermatology treatment landscape. AJMC. March 29, 2026. Accessed April 3, 2026. https://www.ajmc.com/view/emerging-therapies-innovations-highlight-the-evolving-dermatology-treatment-landscape