Spectrum of skin lesions including skin adnexal tumors in a North Indian tertiary care hospital

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Author Details : Megha Bansal, Honey Bhasker Sharma*, Nikhilesh Kumar, Monika Gupta

Volume : 4, Issue : 1, Year : 2019

Article Page : 67-71

https://doi.org/10.18231/2581-3706.2019.0013

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Abstract

Abstract

Aims: This study was undertaken in a tertiary care hospital in North Indian state of Uttar Pradesh to evaluate the pattern of skin diseases and various skin neoplasms in biopsy specimens.

Material and Methods: A retrospective analysis of 109 skin biopsies was undertaken. The neoplasms were categorised as per International Classification of World Health Organization.

Results: Keratinous cyst (59 cases) was the most common non- neoplastic skin lesion and it represented 79.7% of non- neoplastic skin lesions. The most common neoplastic skin lesions were soft tissue tumors of vascular origin encompassing pyogenic granuloma which was 34.2% of skin tumors. Commonest malignant neoplasm was squamous cell carcinoma which is categorized under classification of keratinocytic tumors of skin.

Conclusion:  Histopathological examination is essential for the diagnosis and classification of various skin lesions including skin tumors which helps in proper treatment of the patient.

Keywords: Dermatological, Keratinocytic, Follicular.

Introduction

The incidence of dermatological disease was more in males (62.3%) than females with a male to female ratio of 1.65.

Table3: Distribution of skin lesions (non-neoplastic):

In the present retrospective study, the maximum number of biopsies were in the age group of 31-40 years. Of these the non-neoplastic skin lesions were common in the 21-40 years age group and skin tumors in the 41-50 yrs. This was in contrast to reports by Thamiselvi et al and Sunita et al who recorded the most common age group of >50 years.^[1],^[6]

All the skin lesions including tumors were more common in males (62.3%). This was comparable to studies by Rakesh et al - males 56% and Thamiselvi et al - males 64.6%.^[7],^[6]

 Majority of skin lesions were seen in the head and neck region-68.8% followed by extremities in our study. Ankit et al also reported most tumors in head and neck region.^[8] Thamiselvi reported maximum lesions in extremities -36.5% followed by head and neck region.^[6]

Out of 109 skin biopsies received, 74 lesions were non-neoplastic i.e 67.9% and there were 35 skin tumors.

Keratinous cyst was the most common lesion recorded-79.7% of non-neoplastic lesions in our study. This was comparable to study by Ha and Kim.^[9] Other non-neoplastic lesions diagnosed were granulomatous lesions, dermoid cyst, nevus sebaceous, trichilemmal cyst, calcinosis cutis, rhinoscleroma and hamartoma.

The skin tumors in this study were classified into keratinocytic tumors, appendageal tumors and soft tissue tumors.

The most common keratinocytic tumors were squamous cell carcinoma (11.4% of tumors), followed by seborrhoeic keratosis (8.5%), verruca vulgaris (5.7%) and basal cell carcinoma (5.7%).

 One case with secondaries in skin reported as clear cell tumor was also included.

Squamous cell carcinoma was reported as the most common malignancy followed by Basal cell carcinoma by Sheenam et al and Gundalli et al which was comparable to our study.^[10],^[11] This was in contrast to study by Khalid who reported Basal cell carcinoma as the most common tumor followed by Squamous cell carcinoma.^[12]

Among the appendageal tumors, our study comprised tumors of follicular differentiation, apocrine differentiation and eccrine differentiation. The most common appendageal tumor recorded was Trichoepithelioma (8.5%), of which one case reported was of desmoplastic variant. This was comparable to study by S Gayatri et al who also reported Trichoepithelioma as the commonest adnexal tumor.^[13]

 Ankit et al reported most adnexal tumors in the head and neck region which was similar to our study.^[8]We had two cases of trichoepithelioma in the scalp and third case in infra-orbital region of face. Our study was also comparable to study by Radhika et al in which two cases of trichoepithelioma were reported in scalp.^[14] Study by Abanti Sinha et al showed that all cases of Trichoepithelioma were distributed around nose.^[15]

 Other adnexal tumors reported in our study were Trichilemmoma, Syringocystadenoma papilliferum and Eccrine acrospiroma.

 The adnexal tumors in our study were found in young age group of 11-20 years, which was comparable to study by Nair et al.^[16]

The most common soft tissue tumor found in our study was pyogenic granuloma-34.2% which was also the most common skin tumor found in our study. The second most common soft tissue tumor found was keloid. One case of Dermatofibroma was also included among fibrohistiocytic cutaneous soft tissue tumors.

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Fig. 1: Nevus Sebaceous

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Fig. 2: Seborrhoeic keratosis

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Fig. 3: Squamous cell carcinoma

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Fig. 4: Trichilemmoma

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Fig. 5: Eccrine Acrospiroma

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      Fig. 6: Syringocystadenoma papilliferum

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Fig. 7: Pyogenic granuloma

Conclusion

As per our study, in our area which is in the northern part of India, cystic lesions (keratinous cysts) were the commonest skin lesions, followed by vascular soft tissue tumors (cutaneous pyogenic granuloma).

Conflict of Interest: None.

 

 

 

 

 

 

References

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How to cite : Bansal M, Sharma H B, Kumar N , Gupta M, Spectrum of skin lesions including skin adnexal tumors in a North Indian tertiary care hospital. IP J Diagn Pathol Oncol 2019;4(1):67-71

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