Volume 17, Issue 2 (Mar-Apr 2023)                   mljgoums 2023, 17(2): 7-13 | Back to browse issues page

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Sharma P, Verma R. Histopathological Evaluation of Granulomatous Skin Lesions: A Study from North India. mljgoums 2023; 17 (2) :7-13
URL: http://mlj.goums.ac.ir/article-1-1526-en.html
1- Department of Pathology, Government Medical College, Jammu, India
2- Department of Pathology, AIIMS Rishikesh, India , rahulsrhu@gmail.com
Abstract:   (1298 Views)
Background and objectives: Granulomatous disorders of the skin are frequently encountered in clinical practice and require histopathological confirmation due to a considerable etiological and clinical overlap. A single histopathological pattern may be produced by many causative agents and at the same time, a single cause can present with varied histopathological patterns. The present study was performed to evaluate the histomorphological patterns of granulomas in various granulomatous skin lesions and to identify the causative agents.
Methods: The study (both prospective and retrospective) was carried out in the department of pathology over 5 years. All skin biopsies were evaluated for the presence of granulomas. Detailed analysis of the histopathological pattern of granulomas was performed and categorization was made according to the type and etiology. Special stains were also used when required. A clinicopathological correlation was established with the Kappa statistic.
Results: Of 1,150 skin biopsies, granulomatous skin lesions were observed in 325 cases. Histiocytic granuloma pattern was the most common subtype (55.7%). The predominant etiology of granulomatous inflammation was leprosy (93.5%), followed by cutaneous tuberculosis (2.7%). The cases of Hansen’s disease showed a maximum clinicopathological correlation (58.5%).
Conclusion: Histopathological examination is the gold standard for the diagnosis and subtyping of granulomatous skin lesions. Varied morphologies of granuloma patterns were observed in our study, and infectious diseases were the causative agents in the majority of cutaneous granulomatous disorders. 
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Research Article: Research Article | Subject: Pathology
Received: 2022/05/28 | Accepted: 2022/08/31 | Published: 2023/03/14 | ePublished: 2023/03/14

References
1. Rabinowitz LO, Zaim MT. A clinicopathologic approach to granulomatous dermatoses. J Am Acad Dermatol. 1996 Oct;35(4):588-600. [View at Publisher] [DOI:10.1016/S0190-9622(96)90686-6] [PubMed] [Google Scholar]
2. James DG. A clinicopathological classification of granulomatous disorders. Postgrad Med J. 2000; 76(898): 457-65. [View at Publisher] [DOI:10.1136/pmj.76.898.457] [PubMed] [Google Scholar]
3. Tronnier M, Mitteldorf C. Histologic features of granulomatous skin diseases. Part 1: Non-infectious granulomatous disorders. J Dtsch Dermatol Ges. 2015; 13(3): 211-6. [View at Publisher] [DOI:10.1111/ddg.12610] [PubMed] [Google Scholar]
4. Ahmad F, Mittal A, Arora D, Awasthi S, Dutta S, Kumar A. Histopathological study of cutaneous granulomatous lesions. Indian Journal of Pathology and Oncology. 2019; 6(4): 526-29. [DOI:10.18231/j.ijpo.2019.102] [Google Scholar]
5. Zaim MT, Brodell RT, Pokorney DR. Non-neoplastic inflammatory dermatoses. A clinical pathologic correlative approach. Mod Pathol. 1990; 3(3): 381-414. [PubMed] [Google Scholar]
6. Susmitha S, Mamatha K, Sathyashree Kv, Pyla R, Prashant K. Infectious granulomatous dermatoses: Clinico-histopathological correlation in punch biopsy specimens. IP Journal of Diagnostic Pathology and Oncology. 2019; 4(1): 58-62. [View at Publisher] [DOI:10.18231/2581-3706.2019.0011]
7. Norman G, Raja Samuel Bhushanam JD, Samuel P. Trends in leprosy over fifty years in Gudiyatham Taluk, Vellore, Tamil Nadu. Indian J Lepr. 2006 Apr-Jun;78(2):167-85. [View at Publisher] [PubMed] [Google Scholar]
8. Grover S, Agale SV, D'Costa GF, Valand AG, Gupta VK. Clinico-Histopathological Spectrum of Infectious Granulomatous Dermatoses in Western India- A Representative Study from Mumbai. J Clin Diagn Res. 2016; 10(4): EC10-4. [DOI:10.7860/JCDR/2016/16459.7568] [PubMed] [Google Scholar]
9. Bal A, Mohan H, Dhami GP. Infectious granulomatous dermatitis: a clinicopathological study. Indian J Dermatol. 2006;51(3):217-20. [View at Publisher] [DOI:10.4103/0019-5154.27993] [Google Scholar]
10. Jindal N, Shanker V, Tegta GR, Gupta M, Verma GK. Clinico-epidemiological trends of leprosy in Himachal Pradesh: a five year study. Indian J Lepr. 2009; 81(4): 173-9. [PubMed] [Google Scholar]
11. Chakrabarti S, Pal S, Biswas BK, Bose K, Pal S, Pathak S. Clinico-Pathological Study of Cutaneous Granulomatous Lesions- a 5 yr Experience in a Tertiary Care Hospital in India. Iran J Pathol. 2016 Winter;11(1):54-60. [View at Publisher] [PubMed] [Google Scholar]
12. Marcoval J, Servitje O, Moreno A, Jucglà A, Peyrí J. Lupus vulgaris. Clinical, histopathologic, and bacteriologic study of 10 cases. J Am Acad Dermatol. 1992; 26(3 Pt 2): 404-7. [View at Publisher] [DOI:10.1016/0190-9622(92)70062-K] [PubMed] [Google Scholar]
13. Gautam K, Pai RR, Bhat S. Granulomatous lesions of the skin. Journal of Pathology of Nepal. 2011;1 (2):81-6. [DOI:10.3126/jpn.v1i2.5397] [Google Scholar]
14. Hirsh BC, Johnson WC. Pathology of granulomatous diseases. Epithelioid granulomas, Part I. Int J Dermatol. 1984;23(4):237-46. [DOI:10.1111/j.1365-4362.1984.tb01239.x] [PubMed]
15. Grover S, Agale SV, D'Costa G, Valand AG. Non infectious granulomatous dermatoses: A puzzle for dermatologists and histopathologists. J Med Soc. 2017; 31(1):37-42. [View at Publisher] [DOI:10.4103/0972-4958.198444] [Google Scholar]

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