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Racial differences in the frequency of skin biopsy for psoriasis indicate diagnostic uncertainty, according to a research letter published in JAMA Dermatology. Fahad Ahmed and colleagues conducted a cross-sectional study of adults treated at outpatient dermatology clinics to examine skin biopsy frequency as an indicator of diagnostic uncertainty by race and ethnicity among patients with psoriasis. A total of 10,008 patients were included in the study. The researchers found that 4.8% of patients received a skin biopsy for psoriasis. Skin biopsies were performed most frequently among Black patients (9.8%), followed by Asian or other Pacific Islander (4.7%), White (4.1%), unknown race (4.0%), Hispanic (3.7%), and other race patients (1.61%). Compared with White patients, Black patients had significantly higher odds of receiving a skin biopsy for psoriasis in analyses adjusted for sociodemographic and healthcare utilization factors (OR, 2.03). The findings were robust in sensitivity analyses that evaluated both narrower and broader definitions of a skin biopsy for psoriasis.