Histopathological Evaluation of Granulomatous Skin Lesions: A Study from North India (original) (raw)
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A histopathological analysis of granulomatous dermatoses – a single centre experience from Sri Lanka
The Journal of Diagnostic Pathology, 2016
Granulomatous inflammation is a common histological pattern encountered in skin biopsies which pose a diagnostic challenge to pathologists because of overlapping histological features produced by various aetiological agents. We conducted the following study to analyze the aetiological factors and morphological patterns of granulomatous dermatoses in a cohort of Sri Lankan patients from the Central Province. This is a retrospective analysis of skin biopsies dectected to have granulomatous inflammation over a 12 year period at the Department of Pathology, Faculty of Medicine, University of Peradeniya. All biopsies had been assessed using haematoxylin and eosin stain and special stains when necessary. Of the 1547 skin biopsies received, 128 (8.3%) were recognized to have granulomatous inflammation. An infectious aetiology was present in 86.7% (111/128).The most prevalent infectious cause was leprosy, accounting for 39.8% (51/128) followed by the category differential diagnoses in 22 (17.1%) of which had an infectious differential. Cutaneous tuberculosis was the cause in 17 (13.3%) cases. In 102 cases (79.7%) necrosis was absent in the granulomata and when present most were (58%) of suppurative type; typical caseous type necrosis was present in only a few cases. In conclusion, a large majority of granulomatous inflammation is due to infectious causes and leprosy is the leading cause in this study cohort.
Histopathological study of cutaneous granulomatous lesions
IP innovative publication pvt. ltd, 2019
Introduction: Cutaneous granulomatous lesions are very common encountered by pathologist and dermatologists. Granulomatous dermatoses can be seen in infectious as well as non-infectious conditions leading to chronic inflammation. Clinical features are overlapping, a confirmatory causative finding is essential for the management of patient as treatment varies greatly according to cause. Histopathology remains a gold standard for diagnosis as well as further subtyping of granulomatous inflammatory disorders of skin. Materials and Methods: A retrospective study of skin lesion biopsies performed for 2 years and 2 months, from November 2016 to January 2019. Clinical details were obtained from requisition forms and the cases of granulomatous lesions were diagnosed and subclassified with the help of H&E and special stains. Result: The study includes 70 cases. A predominance of male were found with M:F ratio of 1.3:1. 21 to 30 years of age group was the commonest for granulomatous lesions with 34.3% of cases. Infectious granulomatous dermatoses were far high than non-infectious ones. Leprosy remained the major etiology followed by tuberculosis of skin. Conclusion: Leprosy contribute the major cause of granulomatous dermatoses in this study. Histopathology is gold standard for diagnosis and subclassification of cutaneous granulomatous lesion with a proper history and clinical details.
Histopathological study of cutaneous granulomas
Journal of Pathology of Nepal
Background: Cutaneous granulomas comprise a wide spectrum of diseases that are frequently encountered. Since clinical assessment alone is insufficient in most of the cases, skin biopsies are a basic requisite in evaluating these lesions. Histopathological examination, although helpful in deciding the nature of granulomas and etiology in most of the cases, maybe noncontributory in some cases, thus requiring further ancillary tests such as microbial culture, polymerase chain reaction. Materials and Methods: This prospective cross sectional study enrolled 109 cases of skin biopsies after histopathological confirmation of granulomatous lesions. The specimens were received at the Department of Pathology from 14th April 2017 to 13th April 2018. Results: Out of 650 skin biopsies, 109 cases (16.8%) were diagnosed as granulomatous lesions on histology. Male predilection was noted and age group of 31 to 40 years was the commonest affected. Upper extremities were more commonly involved. Lepros...
A COMPARITIVE OVERVIEW OF HISTOPATHOLOGY OF GRANULOMATOUS LESIONS OF SKIN
Sarcoidosis. Histopathology remains a time tested tool for establishing a correct diagnosis. Clinical lesions often reveal surprising underlying pathology. Hence carrying out skin biopsies and microscopic study with routine haematoxylin and eosin (H&E) as well as special stains are must in these disorders so that the type and aetiological agent of the granuloma are properly identified. Besides, follow-up biopsies after the commencement of treatment help in evaluation of the response to therapy. Methods: 52 cases were studied over a period of 2 and a half years. Specimens were collected from the patients of skin, surgery and ENT department. A brief clinical history with age presenting symptoms and signs were recorded. Routine investigations like ESR were performed. Comparison of our study was done with others around the country. Results: Most common type of dermal granuloma was leprosy (59.6%) followed by cutaneous tuberculosis (21.1%), Foreign Body (5.7%), Granuloma Annulare (5.7%), Fungal (5.7%), Actinomycosis (1.9%) and Sarcoidosis (1.9%). Dermal granulomas were most common between the age group of 31 – 50 years. In leprosy and cutaneous tuberculosis, males were affected more as compared to females. Conclusion: Leprosywas most common than other dermal granuloma. Most common type of leprosy and tuberculosis were lepromatous leprosy and lupus vulgaris respectively.
A clinicopathological analysis of non-infectious granulomatous dermatoses
Indian Journal of Pathology and Oncology, 2021
Non-infectious granulomatous dermatoses involves a broad group of distinct reactive inflammatory conditions. They have overlapping morphological and clinical features and hence pose a diagnostic challenge to differentiate from other granulomatous dermatoses and affect the management of the patient. To study the histopathological patterns of non-infectious granulomatous dermatoses and to correlate with clinical features. It is a retrospective study for a period of 5 years at a tertiary care centre in central Karnataka.In the present study, out of 7273 skin biopsies there were 34 cases of non-infectious granulomatous dermatoses. Out of these 34 cases, granuloma annulare (50%) was the most common non-infectious granulomatous lesion followed by annular elastolytic giant cell granuloma (14%), foreign body granuloma (9%), tattoo granuloma (9%) perforating folliculitis (9%), xanthoma(6%) and xanthelasma (3%). Non-infectious granulomatous disorders of skin encompass a large group of disorde...
Non-infectious granulomatous dermatitis –a histomorphological study at a tertiary care centre
IP Archives of Cytology and Histopathology Research, 2020
Background: Non-infectious granulomatous dermatitis is a distinctive reactive inflammatory condition. They are relatively difficult to diagnosis and distinguish both clinically and histologically and most of them are associated with systemic diseases that impact on the overall prognosis. Present study aims at classifying the non-infectious granulomatous dermatitis based on morphology of granulomas, for making an accurate diagnosis. The definitive diagnosis of the granulomatous lesions of skin with identification of etiological agent is very essential for specific treatment and an appropriate desirable outcome. Aims and Objectives: To study the histomorphology of various non-infectious granulomatous dermatitis of skin and classify them, accordingly into different categories. Materials and Methods: A total of 2,690 skin biopsies received to the department of pathology over a period of five year (Jan 2011-Jan 2016) were objectively reviewed using different staining technique. Noninfectious granulomatous dermatitis were identified and classified into different types based on morphology, etiology and also compared among different age groups and genders. Results: Out of total 2,690 skin biopsies received, 314 cases exhibited granulomatous reaction pattern. Among the granulomatous lesions of skin, non-infectious granulomas were seen in 77 cases (2.8%). Among the non-infectious granulomas majority of the cases were mixed cell granuloma seen in 45 cases (58.44%), palisading granuloma in 19 cases (24.67 %), non-specific granulomas/miscellaneous in 10 cases (13 %) and epithelioid cell granuloma without necrosis granulomas in 3 cases (3.9 %). Conclusions: Knowledge of histomorphology of non-infectious granulomatous dermatitis is very important to understand and detect the early and old lesions of dermatitis. This helps in guiding and planning the therapeutic approaches of the dermatitis.
Infectious granulomatous dermatoses: Clinico-histopathological correlation in punch biopsy specimens
IP innovative publication pvt. ltd, 2019
Introduction: Granulomatous dermatoses are group of disorders which are caused by varied etiological agents and includes heterogenous lesions but often share a common histological feature of granuloma formation. Leprosy and cutaneous tuberculosis occupies the major proportion of this category. Leprosy is the most common chronic infectious granulomatous dermatoses caused by mycobacterium leprae. Cutaneous tuberculosis has varied mode of presentation. Materials and Methods: The present study is a one year retrospective study carried out in the Department of Pathology. All the skin biopsies of leprosy cases received in histopathology section from September 2016 to August 2017 were reviewed from the archives of the department. Results: Of 168 skin biopsies, 104 cases were included and remaining 64 cases were excluded. Among 104 cases, 96 cases were leprosy and 8 cases were tuberculosis. It included 73 males and 31 females. Most commonly affected age group was 21-40 years. Majority of the patients were found to have hypopigmented patch. Many of cases were borderline tuberculoid (26 cases) followed by lepromatous leprosy (18 cases). Among the 8 cases of tuberculosis, 4 were lupus vulgaris, 2 were cases of granulomatous chelitis and one cases each of papulonecrotic tuberculid and tuberculosis verrucosa cutis. Conclusion: Diagnosis of leprosy cases should be an integrated approach and includes dermatological, histopathological and microbiological examination. Leprosy is the most common infectious granulomatous dermatitis encountered which was presented clinically with hypopigmented patch. It was found to more common in third and fourth decade of life. This is followed by cutaneous tuberculosis.
The histopathological approach to granulomatous skin lesions
IP innovative publication pvt ltd, 2020
Introduction: Granulomatous inflammation of skin and subcutaneous tissue are common in India. An identical histological picture is produced by several causes. Present study aims at classifying infectious granulomas based on histomorphology and special staining and developing a proper approach for making a specific etiological diagnosis. Aims: To classify the granulomatous dermatitis and a simple diagnostic histological approach has been worked out based on morphology of granuloma, presence of caseous necrosis, palisading necrosis, location of the granuloma and use of special stains. Materials and Methods: A prospective study of skin biopsies with granulomatous inflammation over a period of 2 years is done. Histologically lesions were divided into six subtypes:-Tuberculoid, foreign body type, histoid, necrobiotic, suppurative and sarcoidal type. On basis of morphological features and special staining each type was further subclassified and a specific diagnosis was given. Results: Among 580 skin biopsies, 175 cases (30.17%) were of granulomatous skin lesions. On histopathological typing Tuberculoid type of granuloma was the most common type (62/175 cases, 35.43%) of which leprosy (40/62 cases, 64.52%) was the commonest etiology identified. Infections form an important etiology of granulomatous skin inflammation (120/175 cases, 68.57%) of which leprosy (82/120 cases, 68.33%) is the leading etiology in our study. Conclusion: Adequate clinical work-up in combination with pathological resources help in correctly approaching a granulomatous skin lesion and reaching a specific etiologic diagnosis.
Histopathological Spectrum of Cutaneous Granulomatous Lesions
2020
Background: Cutaneous granulomatous lesions often pose a diagnostic challenge to the pathologists because many of the lesions can clinically as well as morphologically mimick each other. This study was carried out in order to determine the morphology and relative frequency of these lesions and to compare the findings with previously done studies. Materials and methods: A retrospective study of the skin biopsies received in the Department of pathology, FMMC, Mangalore was carried out, and cases of cutaneous granulomatous lesions on histopathological examination and special stains were reviewed. Results: Out of the 84 cases included in the study, male preponderance was noted (71.43%), Maximum number of cases were observed in the patients of age group in the third and sixth decades. Tuberculoid granulomas were the most common type of granulomas (65.48%). Leprosy was the commonest cutaneous granulomatous lesion in the study. Conclusion: In our study, Leprosy was the most common granulom...