A Clinico-pathological Study of Papulonodular Lesions of Skin in a Rural Hospital Setup

.. Rubina, R. Parthibhan, R. Sujitha, Savita Dongapure
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Abstract

Introduction: Skin disorders are a common cause of morbidity in our country, High prevelance of dermatological lesions is seen in tropical countries. The spectrum of lesions varies significantly depending on the geographical region, so accurate diagnosis is of utmost importance as treatment is varied for different skin disorders presenting with similar clinical findings. Aim: To study the spectrum of papulonodular lesions of skin and to evaluate concordance between the clinical and histopathological diagnosis of papulonodular skin lesions. Materials and Methods: This prospective cross-sectional study was conducted in Department of Pathology at MVJ Medical College and Research Hospital, Hoskote, Karnataka, India, from October 2017 to September 2019. The study included 100 skin biopsies that had clinically presented as papules, nodules and as papulonodular lesions. Based on the histopathological findings the lesions were grouped according to aetiology and the final histopathological diagnosis was compared with the clinical diagnosis offered. The slides were stained with Haematoxylin and Eosin, examined under a microscope and findings were noted. Special stains on the tissue sections like Zeihl-Neelson and Fite Faraco were used when required. The qualitative characteristics presented using frequency and percentages, quantitative variables presented using Mean±SD. Results: In the 100 biopsies studied 77 cases were papular, 20 cases were nodular and 3 cases were both papular and nodular. The lesions were common in males (54%) with 67% being in the 21-50 years age group. Lesions were categorised into five aetiological groups based on histology i.e, non infectious papulosquamous (25%), eczematous (23%, Inflammatory (20%), Infectious (11%) and lastly neoplastic (21%). A clinico- pathological association of 79% was observed with differences mainly observed in the eczematous group and tumours. Conclusion: This study highlights the various common skin disorders that can present as papulonodular lesions and the significance of histopathological examination and clinico- pathological association for early diagnosis and management of skin lesions.
农村医院皮肤丘疹性病变的临床病理研究
在我国,皮肤病是一种常见的发病原因,在热带国家,皮肤病的发病率很高。病变的范围因地理区域的不同而有很大差异,因此准确的诊断至关重要,因为临床表现相似的不同皮肤病的治疗方法也各不相同。目的:研究皮肤丘疹样病变的谱,评价丘疹样病变的临床诊断与病理诊断的一致性。材料与方法:本前瞻性横断面研究于2017年10月至2019年9月在印度卡纳塔克邦Hoskote的MVJ医学院和研究医院病理学系进行。该研究包括100例临床表现为丘疹、结节和丘疹样病变的皮肤活检。根据组织病理学结果将病变按病因分组,并将最终的组织病理学诊断与临床诊断进行比较。载玻片用红木精和伊红染色,在显微镜下检查并记录结果。在组织切片上使用特殊的染色剂,如Zeihl-Neelson染色剂和Fite Faraco染色剂。定性特征用频率和百分比表示,定量变量用Mean±SD表示。结果:100例活检中丘疹性77例,结节性20例,丘疹及结节性3例。病变常见于男性(54%),其中67%发生在21-50岁年龄组。病变根据组织学分为五组,即非感染性丘疹鳞状(25%)、湿疹(23%)、炎性(20%)、感染性(11%)和最后的肿瘤性(21%)。临床病理相关性为79%,差异主要见于湿疹组和肿瘤组。结论:本研究强调了各种常见皮肤疾病可表现为丘疹样病变,以及组织病理学检查和临床病理联系对皮肤病变早期诊断和治疗的意义。
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