The honest answer splits in two. If your dermatology practice needs derm-built clinical tooling, body mapping, deep procedure workflows, cosmetic and medical under one roof, the real contenders are ModMed EMA and eZDERM, with Nextech in the mix for aesthetics-heavy practices. If your actual problem is documentation time and quote-only pricing, Patient Square bundles an ambient AI scribe and an AI EHR at a published $119 per clinician per month.
Those are different problems, and most “best derm EHR” lists blur them. This page keeps them separate, names where each vendor genuinely wins, and tells you plainly where we don’t. If you already know documentation is your bottleneck,
Key takeaways
- ModMed EMA has been ranked first in dermatology by Black Book Research for 13 consecutive years, including the 2026 survey. For derm-specific depth, it’s the benchmark.
- The derm-built platforms are quote-priced. Third-party estimates for ModMed EMA run anywhere from $200 to $900+ per provider per month depending on which tracker you read.
- eZDERM is dermatology-only and documents on an anatomical 3D body map tied to location-specific ICD-10 and CPT codes, per its own site.
- A 2020 Journal of the American Academy of Dermatology study put dermatologists’ documentation share at roughly 36% of work time.
- Patient Square has no derm-specific tooling. It has a built-in ambient scribe, a bundled AI EHR, and a price on a public page: $119/mo per clinician, annual.
The two problems a derm EHR gets bought to solve
Problem one is clinical: dermatology documentation has structure most specialties don’t. Lesions need a location precise enough to find again in six months. Biopsies need tracking from shave to path report. A practice running both medical and cosmetic lines needs the record system to handle each without pretending they’re the same business. Derm-built platforms exist because generic EHRs handle this badly.
Problem two is throughput. A general derm schedule runs 30-plus patients a day, and the notes stack up. The 2020 JAAD analysis found dermatologists spending about 36% of their work time on documentation. That’s not a template problem. That’s a “who writes the note” problem, and it’s the one an ambient scribe attacks.
Figure out which problem is actually yours before you shortlist anything. The vendors below split cleanly along that line.
How the five options compare
| EHR | Built for derm? | Known for | Pricing |
|---|---|---|---|
| ModMed EMA | Yes | Black Book #1 in dermatology, 13 straight years | Quote-only; third-party estimates $200–$900+ |
| eZDERM | Yes, derm-only | 3D body map on location-specific ICD-10/CPT | Quote-only; third-party estimate $250–$500 |
| Nextech | Yes | Aesthetic and cosmetic derm focus | Custom, typically enterprise-tier |
| DrChrono | No, multi-specialty | Small-practice option with ambient AI | Third-party estimate $199–$499 |
| Patient Square | No, specialty-aware templates | Built-in ambient scribe + bundled AI EHR | Published: $119/mo annual |
All rival figures are third-party estimates from Edvak’s 2026 dermatology buyer guide and Software Finder, not vendor quotes. The spread on ModMed alone ($200 versus $900+) tells you how much a “typical” number hides. Only one row on this table has a price you can read without a sales call, and yes, that’s our row. We think that fact belongs in the comparison itself.
The derm-built platforms, one by one
ModMed EMA
EMA is the default answer in dermatology, and the record backs it: first place in Black Book Research’s dermatology EHR rankings for 13 consecutive years, part of a 2026 sweep across all 11 of ModMed’s specialty EHRs. It was built as a single-specialty system, and the depth shows in derm-specific workflows that generic platforms bolt on later, if ever. The trade-offs are the ones that come with depth: quote-based pricing, implementation costs that third parties peg at $2,000 to $10,000, and real lock-in once your staff is trained into it. Our ModMed alternatives breakdown covers the leaving-versus-staying math in detail.
eZDERM
eZDERM’s pitch is purity: “built only for dermatologists by a practicing dermatologist,” in its own words. The signature feature is the 3D body map, an anatomical model you document on directly, with the site claiming it’s built on location-specific ICD-10 and CPT codes. For medical and surgical derm where lesion location drives everything, that’s a genuinely different way to chart. Pricing isn’t published; Edvak’s estimate lands at $250 to $500 per provider per month.
Nextech
Nextech plays strongest where dermatology shades into aesthetics. Edvak’s 2026 dermatology buyer guide frames it as the pick for cosmetic-forward and high-volume aesthetic practices, with custom, enterprise-tier pricing. If your revenue mix leans cosmetic, it belongs on your shortlist. If you run mostly medical derm, the platforms above fit tighter.
DrChrono
DrChrono isn’t derm-built. It’s a multi-specialty EHR that shows up in derm roundups as the small-practice option, with an ambient AI assistant and third-party pricing estimates of $199 to $499 per provider. It’s the middle path: less specialty depth than EMA or eZDERM, more clinical breadth than a documentation-first bundle.
Where Patient Square fits a dermatology practice
Straight up: we don’t have a 3D body map, a biopsy log module, or cosmetic inventory tooling. If those are hard requirements, pick a derm-built platform and don’t look back.
What Patient Square does have is the other half of the problem. AI Medical Scribe by Patient Square is one module inside Practice Copilot: it listens during the visit and hands back a structured SOAP note, ICD-10 suggestions, and a prescription draft, ready to review and sign about two minutes after the visit. Say “8 millimeter hyperpigmented plaque, left medial calf, irregular border” during the exam and that’s what the note carries, in your words. The Copilot plan bundles that scribe with the AI Copilot EHR at $119 per clinician per month on annual billing, unlimited visits and notes, no per-note metering. Specialty-aware templates ship ready out of the box, and every note is available as an EHR-ready export (PDF · HL7 · FHIR).
How the scribe handles lesion descriptions and spoken procedure narration is its own topic; the dermatology scribe guide walks through it finding by finding. Security posture, BAAs included for every customer, is on the security page.
So the fit is a specific one: derm practices whose charting burden outweighs their need for specialty modules, and practices that want a number on a page instead of a quote form. That’s a real segment. It’s not every segment.
When ModMed EMA or eZDERM is the better fit
Choose ModMed EMA if your practice lives inside medical and surgical dermatology at scale and you’ll actually use the deep workflows. Thirteen straight years at the top of the specialty’s own survey is derm groups re-choosing it with their own money, year after year. The premium and the lock-in are the price of that depth, and for a mid-size or large derm group, usually a fair one.
Choose eZDERM if precise anatomical documentation is the center of your clinical day, high-volume skin checks, lots of biopsies, lesions you track across years. A 3D body map beats a text field for that job.
Choose Nextech if cosmetic revenue drives the practice.
Choose Patient Square if the notes are the pain, you want the scribe and the record system in one subscription, and you’d rather spend $119 than an unknown number. That’s the honest split. For the broader field beyond dermatology, our EHRs with a scribe built in roundup covers the bundled category.
A one-week way to decide
Book demos with the derm-built vendors and push past the script: bring your three messiest real cases, a complex skin check, a multi-procedure morning, a cosmetic consult, and watch each system chart them end to end. Ask every vendor for the full invoice in writing, base plus implementation plus add-ons, because the sticker is never the total.
Then run the documentation half on your own patients. Patient Square’s 7-day free trial needs no card. Run it on a real Monday clinic, count minutes from room exit to signed note, and compare that number against whatever you do today. Pricing is on the pricing page, and a
Two problems, five vendors, one decision. Buy for the problem you actually have.