An approach toward cutaneous granulomatous lesion: A retrospective analysis in a tertiary care setup

Abstract

Background: Granulomatous disorders of the skin are commonly encountered and pose a diagnostic challenge due to its diverse etiology with several histological patterns. Granulomatous diseases of skin comprise a large family sharing the common histological finding as of granuloma formation. The various histological types of granulomas can be identified on the basis of the constituent cells and other changes within the granulomas. However, significant overlap exists in histopathological findings of different granulomatous reactions. Thus, morphology alone is seldom specific and cannot be used as a diagnostic tool for the identification of specific diseases. A keen understanding of the manifestations, workup, and subsequent treatment of both infectious and noninfectious cutaneous granulomatous lesion is essential for every practicing clinician and dermatopathologist. Materials and Methods: A 2-year retrospective study involved all the skin biopsies. Detailed clinical and histopathological features were analyzed and were categorized according to the type of granuloma. Special stains were used in few cases for diagnostic purposes. Cases were reviewed and analyzed. Results: In histopathological subtyping, tuberculoid granuloma was the most common type and the most common etiology was leprosy. Others were cutaneous tuberculosis, foreign body granulomas, fungal lesions, cutaneous leishmaniasis, and granuloma annulare. Conclusion: Histopathology when combined with special stain can serve as a gold standard investigation for diagnosis, categorization, and clinicopathological correlation in such cases.

Keywords

• granuloma
• histopathology
• special stains