Skin Appendageal Tumours: An Institutional Experience from Northern India

Abstract

Introduction: Skin Appendageal Tumours (SAT) are a heterogenous group of rare tumours having differentiation towards the skin appendageal structures and are rarely considered clinically as a differential diagnosis. A couple of studies and case series are available in literature from different parts of India but only meagre work is published from northern India. Aims: To study the spectrum of clinicopathological features of SAT in northern India, classify them according to WHO classification and to compare the outcome with published data in literature. Materials and Method: This retrospective and prospective study included 64 cases of histologically confirmed SAT at a tertiary care hospital located in northern India. The relevant clinical data including patient’s age, gender, site alongwith histopathological features of the tumour were analysed. Tumours were classified as per WHO classification (2006). The data was then compared with the previous studies. Results: Of the 64 cases diagnosed as skin appendageal tumour, 52 (81.25%) were benign, while 12 (18.75 %) were malignant. Male to female ratio was 1:1.29. People in third decade of life were more commonly affected closely followed by 6th and 7th decades. Head and neck was the commonest site (39/64; 60.93%), followed by upper extremities (10/64; 15.62%) and trunk (8/64;12.50%). Tumours with follicular differentiation formed the major group (33/64; 51.56%). Pilomatricoma (24/64; 37.5%) and proliferating trichilemmal tumour (6/64; 9.38%) were the commonest benign and malignant tumours respectively. One of the cases diagnosed as sebaceoma was associated with Muir Torre syndrome. Conclusion: SAT should be suspected if there is a subcutaneous papulonodular lesion especially in head and neck region. Histopathological diagnosis and sub classification of SAT is often difficult, but following a widely accepted WHO classification system, may help to minimize conflicts and dilemma.

Keywords

• apocrine and eccrine tumours
• follicular tumours
• pilomatricoma
• proliferating trichilemmal tumour
• sebaceous tumours