Pattern of granulomatous skin lesions in a tertiary care centre of western Uttar Pradesh (original) (raw)
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Histopathological Evaluation of Granulomatous Skin Lesions: A Study from North India
Medical Laboratory Journal , 2023
ABSTRACT Background and objectives: Granulomatous disorders of the skin are frequently encountered in clinical practice and require histopathological confirmation due to a considerable etiological and clinical overlap. A single histopathological pattern may be produced by many causative agents and at the same time, a single cause can present with varied histopathological patterns. The present study was performed to evaluate the histomorphological patterns of granulomas in various granulomatous skin lesions and to identify the causative agents. Methods: The study (both prospective and retrospective) was carried out in the department of pathology over 5 years. All skin biopsies were evaluated for the presence of granulomas. Detailed analysis of the histopathological pattern of granulomas was performed and categorization was made according to the type and etiology. Special stains were also used when required. A clinicopathological correlation was established with the Kappa statistic. Results: Of 1,150 skin biopsies, granulomatous skin lesions were observed in 325 cases. Histiocytic granuloma pattern was the most common subtype (55.7%). The predominant etiology of granulomatous inflammation was leprosy (93.5%), followed by cutaneous tuberculosis (2.7%). The cases of Hansen’s disease showed a maximum clinicopathological correlation (58.5%). Conclusion: Histopathological examination is the gold standard for the diagnosis and subtyping of granulomatous skin lesions. Varied morphologies of granuloma patterns were observed in our study, and infectious diseases were the causative agents in the majority of cutaneous granulomatous disorders. Keywords: Antibodies, Antinuclear, Lupus Erythematosus, Systemic, ELISA, Diagnosis.
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.
2020
Background: Granulomatous skin diseases are one ofthe leading causes of morbidity in tropical countrieslike Nepal. These granulomatous skin lesions oftenpose diagnostic challenge to clinicians as well as todermatopathologists. Histopathologic examinationof a biopsy specimen represents one of the mostinformative and cost-effective procedure and may helpto avoid other, costlier and invasive diagnostic workup. Materials and Methods: This cross-sectionalobservational study from October 2018 to October 2019,at department of dermatology, enrolled 142 cases ofskin biopsies. Correlation between clinical impressionand histopathological findings was evaluated. Results: Out of 13940 dermatology visits/consultations, 142 (1.01%) skin biopsies wereperformed. Head, neck and face were the commonestsites of biopsies (29.6%). The most commonbiopsy technique was incisional type in 70 (50.4%).Histopathology showed granulomatous features in 49(34.8%) cases, out of which tuberculoid type was thecommones...
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...
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...
Granulomatous dermatosis: histopathological study in a tertiary care hospital
International Journal of Research in Medical Sciences
Background: Granulomatous dermatosis shares the histological finding of granuloma formation; it is usually formed because of the persistence of a non-degradable product of active hypersensitivity. The identical histological picture may be produced by several causes, which pose a diagnostic challenge to dermatopathologist, Present study aims at classifying cutaneous granulomatous dermatosis based on the morphology and aetiology of granulomas, and to highlight its significance for specific clinical diagnosis.Methods: A retrospective analysis of skin biopsy was done and cases of cutaneous granulomatous lesions diagnosed on histopathological examination were retrieved for a period of 8 years. Clinical data and diagnosis were retrieved from hospital records. Hematoxylin and eosin stained paraffin sections were reviewed. The morphological pattern of granuloma was classified into sarcoidal, necrotizing, necrobiotic and suppurative granulomas and further aetiological evaluation for the gran...
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 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.
A histopathological study of granulomatous lesions
Journal of Pathology of Nepal
Background: Granulomas are the commonest lesions that the pathologists come across in routine practice. Granulomatous inflammation is a special type of chronic inflammation that is a manifestation of many infective, toxic, allergic, autoimmune and neoplastic diseases and also conditions of unknown etiology. The aim of this study is to analyze different granulomatous lesions and to find the frequency and etiology of all granulomatous lesions.Materials and Methods: The study included a total of 218 granulomatous lesions, received over a period of one year from July 2013 to June 2014 in the department of pathology, TUTH. Special stains like Ziehl-Neelsen, PAS and Wade- Fite- Faraco were done whenever required.Results: Granulomatous lesion accounted for 3% of all biopsies. The median age of the patients was 29 years and the majority of the patients were in the age group of 20-29 years with no sex predilection. Majority of granulomas were seen in lymph nodes (32.1%), followed by skin and...