Technology and AI Tools in Dermatologic Surgery

Conclusions

• OpenEvidence appears to be a safer and more clinically useful LLM than general-purpose chatbots because it relies on vetted medical sources, includes guardrails, and is HIPAA compliant when used appropriately.
• Ambient AI documentation can reduce clinician burnout, task load, and sometimes note-writing time, but its effect on documentation efficiency is mixed and varies by specialty.
• AI-generated clinical notes are generally judged to be comparable in quality to manually written notes, but they still require careful human editing and do not yet work well for every note type.
• The greatest practical benefit of ambient scribes may be in complex, conversation-heavy encounters where they can draft most of the note and reduce after-hours charting burden.
• The usefulness of ambient AI is not uniform across specialties, with primary care benefiting more consistently than medical or surgical subspecialties.
• Personalized risk calculators for cutaneous squamous cell carcinoma can help guide treatment decisions most effectively in intermediate-risk cases where staging alone is less informative.
• The proposed COMPASS staging system aims to unify and improve prognostication for cutaneous squamous cell carcinoma by integrating multiple staging frameworks and tumor features.
• AI for frozen-section pathology currently performs well for whole-slide classification of basal cell carcinoma, but that task is less clinically useful than precise tumor localization.
• Segmentation of basal cell carcinoma on Mohs frozen sections remains imperfect, with false positives and false negatives limiting current clinical deployment.
• Certain basal cell carcinoma subtypes, especially micronodular and infiltrative patterns, are harder for AI models to detect than nodular or superficial subtypes.
• A more clinically meaningful future direction for pathology AI is outcome-based assistance that aligns model output with Mohs maps and surgeon decision-making rather than abstract segmentation metrics.
• Simple communication headsets remain a practical, inexpensive way to improve teamwork and workflow in dermatologic surgery despite some usability drawbacks.