Histopathological Study of Skin Lesions in a Tertiary Care Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Skin diseases are much common in developing countries. The spectrum varies according to geographic distribution, gender, age, and coexisting disorder. We conducted this study to find out the prevalence of different skin lesions and to evaluate their frequency and site of distribution. METHODS: A descriptive cross-sectional study was done in the pathology department of Kathmandu Medical college from June 2019 to November 2019 after ethical clearance. The skin biopsies were processed, sectioned and stained with Haematoxylin and eosin and evaluated. A convenience sampling method was used. Data was collected and entry was done in Statistical Packages for Social Services version 20.0, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 133 skin biopsies examined, noninfectious vesicobullous and vesicopustular disease were found in 42 (46.6%) cases followed by microbial disease in 22 (24.5%) and noninfectious erythematous papular and squamous disease in 21 (23.4%) cases. Spongiotic dermatitis was the most common vesicobullous disease seen in 26 (28.9%) cases. Leprosy was the commonest microbial disease found in 7 (7.8%) cases. The commonest noninfectious erythematous papular and squamous disease was erythema dyschromicum perstans seen in 7 (7.8%) cases. The commonest neoplastic lesion was keratinocytic tumor seen in 12 (32.5%) cases. The commonest tumor of the skin was intradermal nevus seen in 6 (16.3%) cases. CONCLUSIONS: Spongiotic dermatitis is a predominating non-neoplastic and overall skin lesion which was similar to the other studies done. Histopathological examination is the gold standard for the proper diagnosis as histomorphological features distinguish various skin lesions.

Predisposing factors and histopathological variants of cutaneous squamous cell carcinoma: Experience from a North Indian teaching hospital.

BACKGROUND: Squamous and basal cell carcinomas together constitute the majority of non-melanoma skin cancers. These malignancies are infrequent in Indians as compared to the white skinned population. Literature on squamous cell carcinoma in dark skin is limited. AIM: To analyze the risk factors and to characterize the histopathological subtypes of cutaneous squamous cell carcinoma in Indian patients in an area, non-endemic for arsenicosis. METHODS: A retrospective analysis of data from January 2003 to August 2013 was performed to evaluate the predisposing factors and histopathological types of cutaneous squamous cell carcinoma at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh. Demographic and disease characteristics such as age, gender and predisposing factors, particularly premalignant dermatoses were recorded and histopathology slides were reviewed. RESULTS: Of the 13,426 skin biopsy specimens received during the 10-year period, there were 82 (0.6%) cases of squamous cell carcinoma and 170 (1.7%) of basal cell carcinoma. The mean age at diagnosis of cutaneous squamous cell carcinoma was 53.7 years and the male to female ratio was 2:1. The most common site of involvement was the lower limbs in 34 (41.5%) patients. Marjolin's ulcer was present in 36 (43.9%) cases. No predisposing factor was identified in 35 (42.7%) patients. Histopathologically, the tumors were classified most commonly as squamous cell carcinoma not otherwise specified in 33 (40.2%) cases. LIMITATIONS: This was a retrospective study and details of occupation and interval between the precursor lesions and development of tumor were not recorded. Immunohistochemistry for human papilloma virus and p53 tumor suppressor protein were not performed as these tests were not available. CONCLUSION: Cutaneous squamous cell carcinoma is uncommon in Indian patients and a high index of suspicion is necessary when a rapidly enlarging nodule, verrucous fungating plaque or an ulcer with everted margins develops in long standing scars and other predisposing dermatologic conditions. Histopathological examination is mandatory to confirm the diagnosis and identify the subtype and this has prognostic implications.

Morphometric study of microvessels, epidermal characteristics and inflammation in psoriasis vulgaris with their correlations.

BACKGROUND: Vascular proliferation, inflammation and epidermal changes are important features in the pathogenesis of psoriasis. AIMS: In this study we attempted an objective evaluation of these parameters using morphometry. METHODS: Inflammation, microvessels and epidermal parameters were assessed in 50 newly diagnosed cases of psoriasis vulgaris (between 01 Nov 2008 and 31 Oct 2011) by morphometry. Parameters studied were microvessel density, microvessel caliber, inflammatory cell density in dermis, ratio between inner and outer epidermal length, maximum epidermal thickness, minimum epidermal thickness and difference between maximum epidermal thickness and minimum epidermal thickness. RESULTS: Microvessel caliber showed moderate correlation (r = 0.645) and microvessel density, weak correlation (r = 0.226) with inflammatory cell density in dermis. Both these parameters also showed mild positive correlation with "ratio between inner and outer epidermal length". All parameters except minimum epidermal thickness showed mild positive correlation with inflammatory cell density in dermis. CONCLUSION: All microvessels and epidermal parameters showed positive correlation with dermal inflammation; and epidermal parameters exhibited positive correlation with micro-vascular dilation. It is likely that inflammation is a key factor in the pathogenesis of psoriasis.

[Non-tumor dermatoses diagnosed in the pathologic anatomy laboratory of the Tokoin University hospital center, Lomé (Togo)]. / Les dermatoses non tumorales diagnostiquées dans le laboratoire d'anatomie pathologique du CHU Tokoin, Lomé (Togo).

The non-tumorous skin diseases are common in hospital consultation in tropical countries. These infections constitute a great health problem in black Africa. Their diagnosis is often clinically easy, but sometimes histologically examination is necessary to have the positive diagnosis. In Togo, a retrospective study conducted during ten years, allowed to note 516 cases of non-tumoural dermatosis which were histologically diagnosed. The principal infections were: inflammatory dermatosis 339 cases (213 cases were not specific against 108 specific cases predominated by leprosy: 82 cases), epidermal dermatosis (97 cases, predominated by eczema and psoriasis), dermal lesions (44 cases), lesions of dermic and epidermic junction (23 cases), hypodermic (13 cases). The results of this study shows the diversity of non-tumorous dermatosis diagnosed by the histology. The eradication of these diseases in Africa needs to have efficient laboratory diagnosis and research means in every country.