A clinicopathological analysis of non-infectious granulomatous dermatoses (original) (raw)
Related papers
Pattern of granulomatous skin lesions in a tertiary care centre of western Uttar Pradesh
Indian Journal of Pathology and Oncology, 2021
Granulomatous skin lesions frequently present as a diagnostic challenge to the pathologist because of various modes of presentation. Both infectious and non infectious causes lead to cutaneous granulomas. Histopathological diagnosis is required to confirm the clinical diagnosis and to classify the cutaneous granulomatous lesions. To study the spectrum, prevlance and frequency of various types of granulomatous skin diseases according to the age and sex of the patient. A cross-sectional type of observational study was carried out in the department of pathology, Rohilkhand medical college and hospital, Bareilly, Uttar Pradesh for the duration of 12 months (November 2018-October 2019). Punch biopsies received were fixed, grossed and processed, with the standard methods and were stained with hematoxylin and Eosin stain. All these biopsies were examined under the microscope and the slides in which granulomatous skin lesions were seen were selected for the study. Special stains were used w...
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.
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.
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...
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...
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.
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...