Histopathology of Papulosquamous Skin Lesions: A Prospective Cohort Study of 305 Cases

Abstract

ABSTRACT Introduction: Papulosquamous lesions are a heterogeneous group of disorders and they form the largest group of skin diseases. They are characterized clinically by scaly papules and plaques and are usually erythematous. These lesions show considerable overlap in clinical and histopathological features. Materials and Methods: The present prospective cohort study was carried out at an urban teaching medical hospital. Histopathological features of 305 skin biopsies of clinically diagnosed as papulosquamous lesions were studied in detail for 3 years from February 2020 to February 2023. Histological features were correlated with clinical features and a final diagnosis was made. Standard statistical tests were applied to analyze data. Microsoft Excel was used to express tables and data were expressed in percentile and numerical. Results: Statistical analysis was done. The most common clinical lesions were papules (49.50%) followed by plaques (43.27%) and both papules and plaque (34.42%). Maximum cases were of lichen planus (n = 120) followed by psoriasis (n = 98). The least common lesion was lichen nitidus (n = 2). Out of 305 cases, 52.13% were female (n = 159) and 47.86% were male (n = 146). Out of 146 male patients, 35.61% of lesions were psoriasis (n = 52) followed by 33.56% lichen planus (n = 49). Out of 159 female patients, 44.65% were lichen planus (n = 71) as compared to 28.93% psoriasis (n = 46). Conclusion: Papulosquamous lesions show considerable overlap in clinical and histopathological features. Specific histopathological diagnosis is important to distinguish these lesions because in these disorders, prognosis, and treatment vary significantly. There is a need for lucid clinical information and description of these lesions to correlate with histological features which enables definitive histopathology diagnosis.