Non-infectious granulomatous dermatitis –a histomorphological study at a tertiary care centre

Abstract

Background: Non-infectious granulomatous dermatitis is a distinctive reactive inflammatory condition. They are relatively difficult to diagnosis and distinguish both clinically and histologically and most of them are associated with systemic diseases that impact on the overall prognosis. Present study aims at classifying the non-infectious granulomatous dermatitis based on morphology of granulomas, for making an accurate diagnosis. The definitive diagnosis of the granulomatous lesions of skin with identification of etiological agent is very essential for specific treatment and an appropriate desirable outcome. Aims and Objectives: To study the histomorphology of various non- infectious granulomatous dermatitis of skin and classify them, accordingly into different categories. Materials and Methods: A total of 2,690 skin biopsies received to the department of pathology over a period of five year (Jan 2011-Jan 2016) were objectively reviewed using different staining technique. Noninfectious granulomatous dermatitis were identified and classified into different types based on morphology, etiology and also compared among different age groups and genders. Results: Out of total 2,690 skin biopsies received, 314 cases exhibited granulomatous reaction pattern. Among the granulomatous lesions of skin, non-infectious granulomas were seen in 77 cases (2.8%). Among the non-infectious granulomas majority of the cases were mixed cell granuloma seen in 45 cases (58.44%), palisading granuloma in 19 cases (24.67 %), non-specific granulomas/miscellaneous in 10 cases (13 %) and epithelioid cell granuloma without necrosis granulomas in 3 cases (3.9 %). Conclusions: Knowledge of histomorphology of non-infectious granulomatous dermatitis is very important to understand and detect the early and old lesions of dermatitis. This helps in guiding and planning the therapeutic approaches of the dermatitis. Keywords: Histomorphology, Skin, Foreign body, Rheumatoid nodule.