Journal of Clinical and Investigative Dermatology
Research Article
Comparing Clinical vs Histopathological Features in Diagnosing Erythemato-Squamous Diseases
Shenouda MG1,2, Travers JB1,2,3* and Sun S4
1Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA
2Departments of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
3Department of Dermatology, Wright State University, Dayton, Ohio, USA
4Department of Mathematics and Statistics, Wright State University, Dayton, Ohio, USA
2Departments of Pharmacology and Toxicology, Wright State University, Dayton, Ohio, USA
3Department of Dermatology, Wright State University, Dayton, Ohio, USA
4Department of Mathematics and Statistics, Wright State University, Dayton, Ohio, USA
*Address for Correspondence:Jeffrey B. Travers, Wright State University Department of
Pharmacology and Toxicology, 3640 Colonel Glenn Hwy, Dayton, OHIO. USA. E-mail Id: jeffrey.travers@wright.edu
Submission: 21 February, 2026
Accepted: 24 March, 2026
Published: 26 March, 2026
Copyright: ©2026 Shenouda MG, et al. This is an open access
article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited.
Keywords:Erythemato-squamous diseases; Clinical features; Histopathology;
Diagnostic classification; UCI Dermatology dataset; Logistic regression; Predictive accuracy
Abstract
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.
