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

Abstract

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.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. 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%).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.