A Nature Medicine study tested explainable AI for dermatology with 623 lay people and 153 primary care physicians. Fairness trained models that balanced performance across skin tones improved accuracy and cut tone related gaps for both groups. Multimodal LLM explanations amplified automation bias among lay users, helping when the model was right and hurting when it erred, while physicians stayed more resilient. Showing the AI diagnosis first strengthened anchoring. Why it matters: chatty explanations can make consumer dermatology AI feel safer than it is. Caveat: the tasks differed by cohort, so public and clinician effects are not a single head to head score.