A comparative overview of histopathology of granulomatous lesions of skin

ABSTRACT

Granulomatous lesions of the skin and subcutaneous tissue are common in India. They are known as “Dermal Granulomas”. In present study following types of Dermal Granulomas were included – Leprosy, Cutaneous Tuberculosis, Syphilis, Fungal, Actinomycosis, Foreign body Granuloma, Granuloma annulare and 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.