A Clinicopathological Study of Inflammatory Dermatoses

Abstract

Introduction: The instant pattern recognition seen in neoplastic, and few infectious disorders is not seen in inflammatory dermatoses. An overall assessment of the clinical features and microscopic features aids in the diagnosis of inflammatory lesions which have several overlapping features in common. Inflammatory dermatoses include psoriasiform diseases, lichenoid diseases, vasculopathic diseases, spongiotic diseases and vesiculobullous diseases. Aim: The current study is aimed to evaluate the pathological findings in inflammatory skin lesions and to compare with the pathological with clinical findings. Material and methods: This is a study conducted at GITAM institute of medical sciences and research for a period of 18 months i.e., from January 2022 to June 2023. All the skin biopsies received at the department of pathology, GIMSR. Using 10% formalin they were subjected to fixation and processed in automatic tissue processor and after taking 3-4 microns sections, staining was done with eosin and hematoxylin and a final histopathological diagnosis was made. Results: The patterns of various tissue reactions were observed in our study were Lichenoid reaction pattern (23%), Psoriasiform reaction pattern (39%), Spongiotic reaction pattern (22.7%), Vesiculobullous reaction pattern (4.5%), Vasculopathic reaction pattern (7.9%).In our study the most common inflammatory dermatoses observed was psoriasis 26% (23 cases), variants of lichen planus 12.5% (11 cases), pityriasis Rosea 6.8% (6 cases) followed by 5.6% (5 cases) spongiotic dermatitis and leucocytoclastic vasculitis each. In 72 cases (82%) there was agreement between the clinical and histological diagnoses, whereas in 16 cases (18%) there was a discrepancy. Conclusion: To narrow the differential diagnosis and arrive at the most accurate diagnosis, a systematic approach during histopathological assessment and sorting inflammatory dermatoses based on the reaction pattern are crucial.