Comparing Clinical vs Histopathological Features in Diagnosing Erythemato-Squamous Diseases

Erythemato-squamous diseases (ESDs) possess overlapping clinical manifestations and diverse histopathological profiles, thus presenting diagnostic challenges. There remains a need for improved diagnostic approaches that integrate clinical and histopathological features. The objective of these studies is to investigate the relative value of clinical versus histopathological features in distinguishing among six ESD classes. The University of California, Irvine (UCI) Dermatology dataset includes 366 patients diagnosed with one of six ESDs and their corresponding clinical and histopathological features. Data were analyzed using paired t-tests. Multiple logistic regression (MLR) models were constructed for each ESD class to assess the predictive strength of clinical and histopathological features. Paired t-tests revealed a statistically significant difference between clinical and histopathological averages across the dataset (p < 2.2e-16), with clinical features generally more pronounced. This trend was consistent across all disease classes except chronic dermatitis, where no significant difference was observed (p = 0.8102). Multiple logistic regression models demonstrated high predictive performance across all six ESD classes, with pityriasis rubra pilaris achieving the highest predictive accuracy of 94.5%. Clinical features exhibited higher average severity across the dataset; however, this does not necessarily translate into diagnostic dominance, which varies by disease class. For conditions like lichen planus, histopathological features provided stronger predictive power. Our results underscore the complementary roles of clinical and histopathological data and support the development of integrated models for improving classification accuracy and data-driven diagnostic strategies in dermatology.