The fast development of virtual healthcare systems has created new paths for artificial intelligence (AI) early diagnosis and management of skin disorders. Still, questions about trust, security, and interpretability impede general adoption. To solve these problems, this chapter investigates a synergistic framework combining blockchain technology with explainable artificial intelligence (XAI). XAI helps doctors and patients comprehend and validate automated judgments by offering human-interpretable insights into AI-driven skin disease categorization, hence improving diagnostic transparency. Through distributed, tamper-proof ledgers, blockchain concurrently guarantees data integrity, patient privacy, and safe exchange of medical records. These technologies used together build a reliable environment for virtual dermatological treatments. We address architectural models, practical uses, possible integration techniques, and the ethical consequences of implementing such systems as well as their limits. This chapter presents a thorough view of how XAI and blockchain may together improve the dependability, responsibility, and user confidence in AI-powered virtual healthcare solutions for skin disease diagnostics.