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The clinical differential diagnosis of a patient with erythroderma is extensive and includes such entities as psoriasis, lymphoma, and pityriasis rubra pilaris. There is some debate in the literature about whether skin biopsy is helpful in determining the cause of erythroderma. To determine whether histology is helpful in diagnosing psoriasis as a cause of erythroderma, this study examined histologic findings in skin biopsies taken from 45 erythrodermic patients with known psoriasis.
In 88% of the cases the histologic findings were strongly suggestive of psoriasis. However, in most cases the histopathologic changes were not characteristic of classic plaque-type psoriasis but rather of early psoriatic lesions, such as slight epidermal hyperpl…