A Clinico-pathological Study of Papulonodular Lesions of Skin in a Rural Hospital Setup

Introduction: Skin disorders are a common cause of morbidity in our country, High prevelance of dermatological lesions is seen in tropical countries. The spectrum of lesions varies significantly depending on the geographical region, so accurate diagnosis is of utmost importance as treatment is varied for different skin disorders presenting with similar clinical findings. Aim: To study the spectrum of papulonodular lesions of skin and to evaluate concordance between the clinical and histopathological diagnosis of papulonodular skin lesions. Materials and Methods: This prospective cross-sectional study was conducted in Department of Pathology at MVJ Medical College and Research Hospital, Hoskote, Karnataka, India, from October 2017 to September 2019. The study included 100 skin biopsies that had clinically presented as papules, nodules and as papulonodular lesions. Based on the histopathological findings the lesions were grouped according to aetiology and the final histopathological diagnosis was compared with the clinical diagnosis offered. The slides were stained with Haematoxylin and Eosin, examined under a microscope and findings were noted. Special stains on the tissue sections like Zeihl-Neelson and Fite Faraco were used when required. The qualitative characteristics presented using frequency and percentages, quantitative variables presented using Mean±SD. Results: In the 100 biopsies studied 77 cases were papular, 20 cases were nodular and 3 cases were both papular and nodular. The lesions were common in males (54%) with 67% being in the 21-50 years age group. Lesions were categorised into five aetiological groups based on histology i.e, non infectious papulosquamous (25%), eczematous (23%, Inflammatory (20%), Infectious (11%) and lastly neoplastic (21%). A clinico- pathological association of 79% was observed with differences mainly observed in the eczematous group and tumours. Conclusion: This study highlights the various common skin disorders that can present as papulonodular lesions and the significance of histopathological examination and clinico- pathological association for early diagnosis and management of skin lesions.