Abstract
Introduction: Wide spectrums of skin disorders exist in the world. Skin biopsy is a proven method for allying the dermatologist in overcoming the diagnostic dilemmas that occur in consultations. The different level of clinicopathological concordance, either full or partial and discordant study may reflect the agreement between the clinicians and pathologists for diagnosing spectrum of skin disorders.
 Objectives: To analyze the histopathological spectrum of skin diseases emphasizing on the diagnostic significance of its clinicopathological concordance.
 Methodology: This is a prospective cross sectional hospital based study of skin biopsies obtained in the Department of Pathology, at Birat Medical College and Teaching Hospital from Dec 2016 to Jan 2020. Demographic data, nature of lesions, correlation between clinicopathological concordance and histopathological diagnosis were analyzed using SPSS version 16.
 Result: Among 111 skin biopsies, female gender of 19-39 years age groups was predominant. The commonest histopathological diagnosis of skin biopsies was under infectious and bacterial origin category (24.3%) reflecting non-neoplastic nature mostly. The overall clinicopathological concordant was 78.38% (fully concordant 27.93% and partially concordant 50.45%) and discordant 21.62%. Nature of lesions was strongly correlated (p<0.05) with age group, while it was weak with gender. However, the relationship was very strong between histopathological diagnosis and clinicopathological concordance (p<0.05%).
 Conclusion: Findings suggest that the clinicopathological concordance correlated well in histopathologically diagnosed disease category of skin disorders. This reflects the high diagnostic value of histopathological examinations for diagnosing different spectrum of skin disorders.
Highlights
Skin being the largest organ of the human body, acts as a barrier to the different environmental factors
Findings suggest that the clinicopathological concordance correlated well in histopathologically diagnosed disease category of skin disorders
The most common histopathological diagnosis of skin biopsies was of bacterial origin (24.3%) under the infec ous category and the rare histopathological diagnosis was under mesenchymal, photodermatoses, vasoprolifera ve and vesiculobullous disorder, each comprising 0.1% respec vely. (Table 2)
Summary
Skin being the largest organ of the human body, acts as a barrier to the different environmental factors. Around 1.3% of pa ents a ending the dermatology clinic need a skin biopsy.[2] histopathological examina on s ll remains gold standard for helping the dermatologist in overcoming diagnos c dilemma.[3] Both the clinical and histopathological data correla ng each other offers substan al clues in arriving at the accurate diagnosis.[4] Likewise, exact anatomical loca on, dura on and number of the lesions with other related condi ons super add the informa on in confirming the diagnosis.[5] Such clinical informa on incorpora on during evalua on together with clinical knowledge for histopathological examina ons is important to achieve accurate and prompt diagnosis. Some of the studies have examined the clinico-pathological concordance or agreement rate for proper diagnosis of numerous skin disorders, despite of cri cal clinical and histopathological data.[2,3]
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