Histopathological Spectrum of Pigmented Skin Lesions in a Tertiary Care Centre of Nepal

S. Ranabhat, S. Poudel, G. Pun
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Abstract

IntroductionPigmented skin lesions are defined as altered pigmentation of the skin as well as mucous membrane which can present as flat or raised growth and can be blue, brown, black or grey in color. The main aim of the study was to see the histopathological spectrum of pigmented skin disease and compare the clinical and histopathological diagnoses. MethodsIt is observational cross-sectional study conducted in the Department of Pathology of Gandaki Medical College and Teaching hospital from January 2022 to December 2022 and 80 cases were included. ResultsAge of the patient ranged from seven to 89 years and mean ± SD was 49.55 ± 21.73 years. There were 34 (42.6%) males and 46 (57.4%) females with a female: male ratio 1.3:1. The most common site of distribution of pigmented lesions of the skin were face in 44(55%) followed by trunk in 15(18.7%), extremities in 13(16.2%), scalp in 7(8.8%) and genitalia in 1 (1.3%). Histopathological study revealed the most common lesion as melanocytic nevi 14(17%) followed by basal cell carcinoma 11(13.8%), seborrheic keratosis 6(7.6%), Keratoacanthoma 5(6.3%), verrucous epidermal nevus 4(5%) and others cases in few numbers. Clinicopathological agreement was seen in 44 (55%). Conclusions Melanocytic nevi were the most common among the pigmented skin lesion. Other causes of pigmented lesions were due to keratinocytic, vascular and reactive changes. Malignant tumors can sometimes mimic benign lesions. Therefore, histopathological examination remains the gold standard in diagnosing these conditions and provide proper guidance for further management of patients.
尼泊尔三级医疗中心色素性皮肤病变的组织病理学特征
导言色素性皮肤病是指皮肤和粘膜的色素改变,可表现为扁平或隆起的增生,颜色可为蓝色、棕色、黑色或灰色。本研究的主要目的是了解色素性皮肤病的组织病理学特征,并比较临床诊断和组织病理学诊断。方法这是一项观察性横断面研究,于 2022 年 1 月至 2022 年 12 月在犍为医学院和教学医院病理科进行,共纳入 80 个病例。结果患者年龄从 7 岁到 89 岁不等,平均(±SD)为 49.55 ± 21.73 岁。男性 34 例(42.6%),女性 46 例(57.4%),男女比例为 1.3:1。皮肤色素病变最常见的分布部位是面部(44 例,占 55%),其次是躯干(15 例,占 18.7%)、四肢(13 例,占 16.2%)、头皮(7 例,占 8.8%)和生殖器(1 例,占 1.3%)。组织病理学研究显示,最常见的病变为黑素细胞痣 14 例(17%),其次是基底细胞癌 11 例(13.8%)、脂溢性角化病 6 例(7.6%)、角化棘皮瘤 5 例(6.3%)、疣状表皮痣 4 例(5%)和其他少数病例。44例(55%)临床病理结果一致。结论 黑色素细胞痣是最常见的色素性皮肤病变。色素性病变的其他原因包括角质细胞、血管和反应性变化。恶性肿瘤有时会模仿良性病变。因此,组织病理学检查仍是诊断这些病症的金标准,可为患者的进一步治疗提供正确的指导。
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