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Retrospective study of papulonodular skin lesions and their clinopathological correlation

Rupali Patil, Mehul Makdani, Asha Gunjalia, Karan Gandhi, Harshid Patel.




Abstract

Background: Papulonodular lesion of the skin is a more common variety. Various types of diseases manifested with papulonodular lesions surface, for example, infectious diseases, benign neoplastic diseases, and malignant tumors as well as metastatic tumors. Therefore, a brief idea about the clinical history, age, sex, and various sites of lesion is important.

Objectives: To evaluate the incidence of different infectious, benign, and malignant diseases manifested with papulonodular lesions. To study the various papulonodular lesions of skin in relation to different age group, sex, and location. To compare our observation with that of other authors and to correlate clinical data with that of histopathological study.

Materials and Methods: In the present study, from November 2007 to November 2009, total 75 cases of papulonodular lesions were taken for study from Department of Dermatology and Department of Pathology, BJ Medical College and Civil Hospital, Ahmedabad, Gujarat, India. All lesions were studied with respect to clinical history, physical examination, histopathological examination of biopsy material on HE stain and also on special stains when required.

Results: In the present study, 69% of papulonodular lesions of skin were of infectious origin followed by 24% as benign origin and 7% as malignant origin. In infectious lesions, most common is leprosy with incidence of 22.67%, erythema nodosum leprosum 20%, and cutaneous tuberculosis mostly scrofuloderma 8% and Prurigo Nodularis 6.67%. In benign lesions, trichoepithelioma has incidence of 8% and syringoma 5.33%. In malignant lesions, Basal cell carcinoma has incidence of 4% and metastatic carcinoma 2.67%. Clinically, most of infectious lesions are diagnosed and are confirmed by histopathology. In leprosy, clinopathological correlation is 94.12% and in erythema nodosum leprosum, it is 93.33%, while in cutaneous tuberculosis, actinomycosis, and epidermoid cyst, clinopathological correlation is 100% with histopathological diagnosis.

Conclusion: Papulonodular lesion of skin is clinically well diagnosed and better correlated with histopathological examination.

Key words: Cutaneous tuberculosis, leprosy, papulonodular lesions, trichoepithelioma






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