Abstract

Introduction
 Skin disease is common in developing countries but the spectrum varies widely. Skin biopsy is an important tool in confirming or establishing diagnoses in cases with diagnostic dilemmas. And, there may be a discrepancy between clinical and pathological diagnoses. 
 Objective
 To determine the spectrum of histological diagnoses in skin disease and to know the consistency between clinical and pathological diagnoses.
 Materials and methods
 A retrospective review of histological and clinical diagnoses was done at a multi-specialty hospital. A total of 85 cases were included in the study. Clinical and histological data along with demographic details, the site of the biopsy was noted. Concordance between clinical and pathological diagnosis was determined as concordant, partially concordant and discordant.
 Results
 There were 60% female and 40% male patients out of 85 biopsies. The most common age group was 31-40 years and the mean age was 41.24 years. The most common histological spectrum was infectious group in 29.4%, followed by papulosquamous disorders in 22.4% and eczema in 12.9% cases. The concordance between clinical and pathological diagnosis was 60%, while partial concordance was seen in 16.5% and discordance was seen in 23.5% cases.
 Conclusion
 Skin biopsy is an important tool in confirming clinical diagnoses. There is a wide variation of histological diagnoses and concordance with clinical diagnoses may be increased with proper clinical history, physical findings and differential diagnosis.

Highlights

  • Skin disease is common in developing countries but the spectrum varies widely

  • Infections followed by papulosquamous disease and eczema were the three most common groups of histological diagnosis

  • This study found an overall concordance of 76.5% and discordance in 23.5% between clinical and histopathological diagnosis

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Summary

Introduction

Skin biopsy is an important tool in confirming or establishing diagnoses in cases with diagnostic dilemmas. There may be a discrepancy between clinical and pathological diagnoses. Skin biopsy is an important tool to confirm the clinical diagnosis in cases of diagnostic dilemmas. Since it is performed only in specific cases, a high diagnostic yield is always desired. This depends on number of factors like biopsy technique, site of biopsy, adequate sample, appropriate clinical and physical findings etc. There are very few studies on clinico-pathological concordance and none ever reported from Nepal.

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