THE SPECIFICITY OF HISTOPATHOLOGY IN ERYTHRODERMA

Conflicting views about the diagnostic value of skin biopsy in the inv estigation of erythrodermic patients are extant. The objective of the present study was to establish the frequency with which a correct diag nosis can be based on histopathological assessment alone. This was ach ieved by comparison of the ''blinded'' microscopic diagnosis with the final diagnosis (based on combined clinico-pathologic parameters and r esponse to therapy). In a retrospective review of 56 skin biopsies fro m 40 patients with erythroderma, we found a positive correlation betwe en the pathological diagnosis and the final diagnosis in 66%; furtherm ore, when the microscopic characteristics observed in different diagno stic categories were assessed, these proved to simulate those seen in conventional manifestations of the various underlying diseases but ten ded to be subtle in the setting of erythroderma. We conclude that, des pite the homogeneity of the clinical expression of erythroderma, diagn ostic histopathological features of the underlying disease are retaine d in the majority of cases.