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A and B, On follow-up, the patient had erythroderma with islands of sparing and an orange waxy keratoderma on his hands and feet. C, A second biopsy found psoriasiform epidermal hyperplasia, sparse lymphocytic infiltrate, and accentuated cornification with parakeratotic foci and follicular hyperkeratosis. Note that the dermal mucin and vacuolar interface change are still present.
