Histopathological spectrum of Nonneoplastic, nonpigmented skin lesions in a tertiary care centre: A prospective study with clinical perspective

Abstract

Context: Nonneoplastic, nonpigmented skin lesions offer a vast variety of interesting array of histopathological diagnosis. Punch biopsy is a very rapid, effective and noninvasive method towards histopathological diagnosis of such skin lesions. Proper institution of therapy is possible with minimal discomfort. Aim: Aim was to study the histopathology of punch biopsies in a variety of skin in patients attending the dermatology OPD. Also an attempt was made to calculate percentage of different nonneoplastic, nonpigmented skin lesions and compare it with the prevalence. Materials and Methods: Punch biopsies from 103 skin lesions were processed and histopathological examination of the H&E stained sections was done. The patients were followed through the wards after the institution of therapy. Results: Out of 103 punch biopsies, 48 cases were offered a diagnosis of dermatitis, 36 were Vesiculobullous lesions, of which 27 were Pemphigus vulgaris, 6 were bullous pemphigoid, 2 Dariers disease, 2 Pemphigus foliacious, 1 IgA Pemphigus, 9 cases of leprosy, 2 each of psoriasis and Discoid Lupus Erythematosus, 1 case each of scleroderma, Steven Jhonsons disease, lichenoid eruption and focal cutaneous mucinosis. Clinical findings and clinical diagnosis were a great help in arriving at a definitive diagnosis. Conclusion: Nonneoplastic and nonpigmented lesions form a very small portion of surgical pathology specimens. Clinical examination along with histopathological examination of skin together help to arrive at correct diagnosis of diseases. Punch biopsy is a simple, inexpensive, safe OPD procedure, causing minimal discomfort to the patient and no scarring. More skin lesions should be subjected to punch biopsy to know the exact diagnosis and progress of the disease and thus help in better therapeutic intervention.