Study of clinico-histopathological correlation of papulosquamous disorders at tertiary care hospital

Abstract

Introduction: The papulosquamous skin disorders are a diverse set of conditions that constitute the most common diseases seen by dermatologists. There is a lot of overlap in the appearance and distribution of lesions, which makes diagnosis challenging. The skin, the body’s largest organ, responds to pathogenic stimuli in a restricted number of ways. As a result, histological patterns in clinically distinct lesions may be similar. A thorough histological evaluation is considered the gold standard in diagnosing skin disorders, but it has limits, and without clinical information, a definitive specific diagnosis is often impossible. In many circumstances, a diagnosis might be made by comparing histopathological and clinical findings. Materials and Methods: A Prospective study was carried out in the Department of Dermatology from September 2019 to September 2021. Patients presenting with clinically papulosquamous disorder were photographed and a presumptive clinical diagnosis was made based on clinical features; which was confirmed by histopathological examination and correlation between clinical and histopathological findings was studied. Results: The study included 202 patients in which clinico-histopathological correlation was done. In 88.11% cases a positive correlation was established whereas a negative correlation was obtained in 11.89%cases. Psoriasis constituted the highest cases 64(31.68%) followed by lichen planus 52(25.74%). Conclusion: Majority of the papulosquamous disorders have an overlapping clinical presentation as skin reacts in a limited pattern towards any pathologic stimuli. There is a need for clear clinical information and a description of the lesion to assist the histopathologist in arriving at a conclusive diagnosis, which is the gold standard, to overcome the associated complexity in diagnosing and commencing the right treatment. For a more accurate differentiation of various papulosquamous disorders, histopathology is very crucial for appropriate medical management. This is clearly seen and supported by the present study.