The histopathological approach to granulomatous skin lesions

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Original Article

Author Details : Venus Khanna, Nidhi Goel*

Volume : 5, Issue : 1, Year : 2020

Article Page : 57-62

https://doi.org/10.18231/j.jdpo.2020.012

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Abstract

Introduction: Granulomatous inflammation of skin and subcutaneous tissue are common in India. An
identical histological picture is produced by several causes. Present study aims at classifying infectious
granulomas based on histomorphology and special staining and developing a proper approach for making
a specific etiological diagnosis.
Aims: To classify the granulomatous dermatitis and a simple diagnostic histological approach has been
worked out based on morphology of granuloma, presence of caseous necrosis, palisading necrosis, location
of the granuloma and use of special stains.
Materials and Methods: A prospective study of skin biopsies with granulomatous inflammation over a
period of 2 years is done. Histologically lesions were divided into six subtypes:-Tuberculoid, foreign body
type, histoid, necrobiotic, suppurative and sarcoidal type. On basis of morphological features and special
staining each type was further subclassified and a specific diagnosis was given.
Results: Among 580 skin biopsies, 175 cases (30.17%) were of granulomatous skin lesions. On
histopathological typing Tuberculoid type of granuloma was the most common type (62/175 cases, 35.43%)
of which leprosy (40/62 cases, 64.52%) was the commonest etiology identified. Infections form an
important etiology of granulomatous skin inflammation (120/175 cases, 68.57%) of which leprosy (82/120
cases, 68.33%) is the leading etiology in our study.
Conclusion: Adequate clinical work-up in combination with pathological resources help in correctly
approaching a granulomatous skin lesion and reaching a specific etiologic diagnosis.

Keywords: Granuloma, Skin lesion, Approach, Special stains.

How to cite : Khanna V , Goel N, The histopathological approach to granulomatous skin lesions. IP J Diagn Pathol Oncol 2020;5(1):57-62

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