Clinico-Pathological Study of Cutaneous Granulomatous Lesions- a 5 yr Experience in a Tertiary Care Hospital in India

Background: Granulomatous dermatoses are common skin pathology, often need histopathological confirmation for diagnosis. Histologically six subtypes of granulomas found in granulomatous skin diseases tuberculoid, sarcoidal, necrobiotic, suppurative, foreign body histoid type. The aims of the present study were clinicopathological evaluation of granulomatous skin lesions and their etiological classification based on histopathological examination. Methods: It was a five years (Jan 2009 Dec 2013) retrospective study involving all the skin biopsies. Detailed clinical and histopathological features were analyzed and granulomatous skin lesions were categorized according to type of granuloma etiology. Special stains were used in few cases for diagnostic purpose. Results: Among 1280 skin biopsies, 186 cases (14.53%) were granulomatous skin lesions with a ratio 1:24. In histopathological subtyping, tuberculoid granuloma was most common type (126 cases, 67.74%). Most common etiology of granuloma in the study was leprosy (107 cases, 57.52%). Other etiologies were cutaneous tuberculosis, foreign body granulomas, fungal lesions, cutaneous leishmaniasis, sarcoidosis and granuloma annulare. Conclusion: Histopathology is established as gold standard investigation for diagnosis, categorization and clinicopathological correlation of granulomatous skin lesions.