A histopathological study of skin biopsy specimens in a tertiary care hospital with a keynote on clinicopathological correlation
Keywords:
Dermatological lesions, Skin biopsies, Histopathological examination, Clinicopathological correlation
Abstract
Introduction: The prevalence of dermatological lesions is notably high among tropical countries and the spectrum varies significantly with geographical distribution and co-existing disorders leading to many differential diagnoses. A histopathological examination is essential to arrive at a final diagnosis, which paves way for clinicopathological correlation. Materials and Methods: This is an observational study over a period of 10 years in the Department of Pathology at a rural area based tertiary care hospital. Histopathological analysis of 800 skin biopsy specimens was done and slides were stained with hematoxylin and eosin stains with the application of special stains such as Fite-Faraco and Ziehl–Neelsen stains and immunohistochemical stains such as S100 in warranted cases. The data obtained were tabulated and analyzed for clinicopathological correlation. Results: Among 800 cases analyzed, specific histopathological diagnosis was made in 87.9% of cases. Neoplastic skin lesions were seen in 22.4% of cases, whereas 77.6% of cases were non-neoplastic. Leprosy was found to be the most common skin lesion. Clinicopathological correlation showed concordance in 430 cases (54%) with significant correlation in leprosy and malignant melanocytic skin tumors. Conclusion: Granulomatous inflammation is still rampant with leprosy and tuberculosis as the leading causes in spite of extensive programmes and preventive measures. In cases where skin biopsy delivered a non-specific diagnosis, infective or neoplastic etiology was ruled out. The heterogeneity in the clinical presentation of skin diseases makes histopathological examination a gold standard tool to establish both the final diagnosis and clinicopathological correlation.References
1. Singh S, Debnath A, Datta D, Chakravarty S, Chaubey RN. Histopathological Evaluation of Skin Lesions with Special Reference to Skin Adnexal Tumors in a Tertiary Centre of North-Eastern India–A Three Year Study. IOSR-JDMS. 2016;15:34–9.
2. Sarkar SK, Islam A, Sen KG, Ahmed ARS. Pattern of skin diseases in patients attending OPD of Dermatology Department at Faridpur Medical College Hospital, Bangladesh. Faridpur Med Coll J. 2010;5:14–16.
3. World Health Organization. Epidemiology and management of common skin diseases in children in developing countries. Geneva: World Health Organization; 2005.
4. Mehar R, Jain R, Kulkarni C, Narang S, Mittal M, Patidar H. Histopathological study of dermatological lesions - A retrospective approach. Int J Med Sci Public Health. 2014;3:1082-85.
5. Sharma S, Trivedi DP, Vyas R. Evaluation of Epidermal Reaction Pattern and Assessment of Histopathological Findings of Various Skin Disorders. J Contemp Med Res. 2016;3:1755–59.
6. Narang S, Jain R. An evaluation of histopathological findings of skin biopsies in various skin disorders. Ann Pathol Lab Med. 2015;2:A42–A46.
7. Aslan C, Gktay F, Mansur AT, Aydngz kbal E, Gne P, Ekmeki TR. Clinicopathological consistency in skin disorders: A retrospective study of 3949 pathological reports. J Am Acad Dermatol. 2012;66:393–400.
8. Gulia SP, Wadhai SA, Lavanya M, Menon R, Chaudhary M, Kumar SP. Histopathological pattern of skin diseases in a teaching hospital Puducherry. Int J Recent Trend Sci Technol. 2014;11:45-50.
9. Veldurthy V, Shanmugam C, Sudhir N, Sirisha O, Motupalli C, Rao N, et al. Pathological study of non-neoplastic skin lesions by punch biopsy. Int J Res Med Sci. 2015;1985–88.
10. Grover S, Ranyal R, Bedi M. A cross section of skin diseases in rural Allahabad. Indian J Dermatol. 2008;53:179-181.
11. Agarwal D, Singh K, Saluja SK, Kundu PR, Kamra H, Agarwal R. Histopathological Review of Dermatological Disorders with a Keynote to Granulomatous Lesions: A Retrospective Study. Int J Sci Stud 2015;3:66-69.
12. Chakrabarti S, Pal S, Biswas BK, Bose K, Pal S, Pathak S. Clinico-pathological study of cutaneous granulomatous lesions-a 5 yr experience in a tertiary care hospital in India. Iran J Pathol. 2016;11:54-60.
13. Gautam K, Pai RR, Bhat S. Granulomatous lesions of the skin. J Pathol Nepal. 2011;1:81–86.
14. Goyal N, Jain P, Malik R, Koshti A. Spectrum of non neoplastic skin diseases: A histopathology based clinicopathological correlation study. Sch J App Med Sci. 2015;3:444-449.
15. Chichani S, Negi SR, Kalla AR, Gaur S. Study of histopathology of papulosquamous lesion of skin a prospective and retrospective study. IJAR. 2016;2:115–117.
16. Achalkar GV. Clinicopathological evaluation of non-neoplastic and neoplastic skin lesions: A study of 100 cases. Indian J Pathol Oncol 2019;6:118-122.
17. Gaikwad SL, Kumawat UD, Sakhare NA, D’costa GF. Histopathological spectrum of skin lesions - Experience at rural based hospital. International J of Current Research 2016; 8:36223-27.
18. Patel N, Suthar T, Suthar H, Arora A. A study of tumours, tumour like lesions and cysts of epidermis and its appendages. Indian J Clin Exp Dermatol. 2018;4:194-200.
19. Gupta P, Karuna V, Grover K. The histopathological spectrum of skin diseases with emphasis on clinicopathological correlation: A prospective study. IP J Diagn Pathol Oncol. 2018;3:91-95.
20. Petrescu IR, Sajin M, Costache M, Simion G. Basal cell carcinoma miming cutaneous melanoma. Rom J Morphol Embryol. 2011;52:197–201.
21. Hasbún Acuña P, Cullen Aravena R, Maturana Donaire C, Ares Mora R, Porras Kusmanic N. Pigmented basal cell carcinoma mimicking a superficial spreading melanoma. Medwave. 2016 Dec 20; 16:e6805.
22. Vaudreuil AM, Stroud CM, Hsu S. Psoriasis mimicking mycosis fungoides clinically. Dermatol Online J. 2017 May 15;23.
23. Doukaki S, Aricò M, Bongiorno MR. A Rare Presentation of Mycosis Fungoides Mimicking Psoriasis Vulgaris. Case Rep Dermatol. 2009;1:60–5.
24. Elmer KB, George RM. Cutaneous T-Cell Lymphoma Presenting as Benign Dermatoses. Am Fam Physician. 1999;59:2809.
25. Marshall J. Pityriasis rosea; a review of its clinical aspects and a discussion of its relationship to pityriasis lichenoides et varioliformis acuta and parapsoriasis guttata. S Afr Med J. 1956;30:210-8.
26. Verma P, Pathania S, Kubba A. A rare case of unilateral discoid lupus erythematosus mimicking lupus vulgaris. BMJ Case Rep.2017;2017:bcr-2017-222218.
2. Sarkar SK, Islam A, Sen KG, Ahmed ARS. Pattern of skin diseases in patients attending OPD of Dermatology Department at Faridpur Medical College Hospital, Bangladesh. Faridpur Med Coll J. 2010;5:14–16.
3. World Health Organization. Epidemiology and management of common skin diseases in children in developing countries. Geneva: World Health Organization; 2005.
4. Mehar R, Jain R, Kulkarni C, Narang S, Mittal M, Patidar H. Histopathological study of dermatological lesions - A retrospective approach. Int J Med Sci Public Health. 2014;3:1082-85.
5. Sharma S, Trivedi DP, Vyas R. Evaluation of Epidermal Reaction Pattern and Assessment of Histopathological Findings of Various Skin Disorders. J Contemp Med Res. 2016;3:1755–59.
6. Narang S, Jain R. An evaluation of histopathological findings of skin biopsies in various skin disorders. Ann Pathol Lab Med. 2015;2:A42–A46.
7. Aslan C, Gktay F, Mansur AT, Aydngz kbal E, Gne P, Ekmeki TR. Clinicopathological consistency in skin disorders: A retrospective study of 3949 pathological reports. J Am Acad Dermatol. 2012;66:393–400.
8. Gulia SP, Wadhai SA, Lavanya M, Menon R, Chaudhary M, Kumar SP. Histopathological pattern of skin diseases in a teaching hospital Puducherry. Int J Recent Trend Sci Technol. 2014;11:45-50.
9. Veldurthy V, Shanmugam C, Sudhir N, Sirisha O, Motupalli C, Rao N, et al. Pathological study of non-neoplastic skin lesions by punch biopsy. Int J Res Med Sci. 2015;1985–88.
10. Grover S, Ranyal R, Bedi M. A cross section of skin diseases in rural Allahabad. Indian J Dermatol. 2008;53:179-181.
11. Agarwal D, Singh K, Saluja SK, Kundu PR, Kamra H, Agarwal R. Histopathological Review of Dermatological Disorders with a Keynote to Granulomatous Lesions: A Retrospective Study. Int J Sci Stud 2015;3:66-69.
12. Chakrabarti S, Pal S, Biswas BK, Bose K, Pal S, Pathak S. Clinico-pathological study of cutaneous granulomatous lesions-a 5 yr experience in a tertiary care hospital in India. Iran J Pathol. 2016;11:54-60.
13. Gautam K, Pai RR, Bhat S. Granulomatous lesions of the skin. J Pathol Nepal. 2011;1:81–86.
14. Goyal N, Jain P, Malik R, Koshti A. Spectrum of non neoplastic skin diseases: A histopathology based clinicopathological correlation study. Sch J App Med Sci. 2015;3:444-449.
15. Chichani S, Negi SR, Kalla AR, Gaur S. Study of histopathology of papulosquamous lesion of skin a prospective and retrospective study. IJAR. 2016;2:115–117.
16. Achalkar GV. Clinicopathological evaluation of non-neoplastic and neoplastic skin lesions: A study of 100 cases. Indian J Pathol Oncol 2019;6:118-122.
17. Gaikwad SL, Kumawat UD, Sakhare NA, D’costa GF. Histopathological spectrum of skin lesions - Experience at rural based hospital. International J of Current Research 2016; 8:36223-27.
18. Patel N, Suthar T, Suthar H, Arora A. A study of tumours, tumour like lesions and cysts of epidermis and its appendages. Indian J Clin Exp Dermatol. 2018;4:194-200.
19. Gupta P, Karuna V, Grover K. The histopathological spectrum of skin diseases with emphasis on clinicopathological correlation: A prospective study. IP J Diagn Pathol Oncol. 2018;3:91-95.
20. Petrescu IR, Sajin M, Costache M, Simion G. Basal cell carcinoma miming cutaneous melanoma. Rom J Morphol Embryol. 2011;52:197–201.
21. Hasbún Acuña P, Cullen Aravena R, Maturana Donaire C, Ares Mora R, Porras Kusmanic N. Pigmented basal cell carcinoma mimicking a superficial spreading melanoma. Medwave. 2016 Dec 20; 16:e6805.
22. Vaudreuil AM, Stroud CM, Hsu S. Psoriasis mimicking mycosis fungoides clinically. Dermatol Online J. 2017 May 15;23.
23. Doukaki S, Aricò M, Bongiorno MR. A Rare Presentation of Mycosis Fungoides Mimicking Psoriasis Vulgaris. Case Rep Dermatol. 2009;1:60–5.
24. Elmer KB, George RM. Cutaneous T-Cell Lymphoma Presenting as Benign Dermatoses. Am Fam Physician. 1999;59:2809.
25. Marshall J. Pityriasis rosea; a review of its clinical aspects and a discussion of its relationship to pityriasis lichenoides et varioliformis acuta and parapsoriasis guttata. S Afr Med J. 1956;30:210-8.
26. Verma P, Pathania S, Kubba A. A rare case of unilateral discoid lupus erythematosus mimicking lupus vulgaris. BMJ Case Rep.2017;2017:bcr-2017-222218.
Published
2020-01-30
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