THE STUDY ON CLINICOPATHOLOGICAL CORRELATION OF EPIDERMAL LESIONS IN A TERTIARY CARE CENTER – A GAMUT OF NON-NEOPLASTIC TO MALIGNANT LESIONS
DOI:
https://doi.org/10.22159/ajpcr.2025v18i10.55018Keywords:
Basal cell carcinoma, Cutaneous malignancies, Epidermal cysts,, Histopathology, Melanocytic nevi, Seborrheic keratosis, Squamous cell carcinoma, Verrucous lesions.Abstract
Objectives: This study aimed to analyze the histopathological spectrum of epidermal lesions and correlate them with age, gender, and site, highlighting histopathology’s essential role in accurate cutaneous lesion diagnosis.
Methods: This combined prospective and retrospective study was conducted over 2 years in the pathology department of a tertiary care hospital. A total of 182 skin specimens were examined using hematoxylin and eosin staining, with special stains when needed. Clinical data were collected, and cases were histologically classified and statistically analyzed using IBM SPSS Version 24.
Results: The most prevalent category was epidermal cysts, comprising 65.39% of all lesions (119/182), with keratinous epidermal type cysts (41.2%) being the most common subtype. These were frequently seen on the back and face. Other cystic variants included pilar cysts, dermoid cysts, steatocystomas, and infected cysts with abscess formation. Cutaneous malignancies represented 11.54% of cases (21/182), including squamous cell carcinoma, verrucous carcinoma, and five histological variants of basal cell carcinoma, predominantly located on sun-exposed areas such as the face. Benign tumor-like lesions included seborrheic keratosis (7.14%), fibroepithelial polyps (5.49%), verrucous lesions (4.39%), melanocytic nevi (3.85%), and Bowen’s disease (2.19%). Lesions were most common in the 41–50-year age group (23.63%), and females were slightly more affected (M:F ratio 1:1.09). The head and neck region (35.16%) and back (25.82%) were the most common anatomical sites.
Conclusion: This study emphasizes the predominance of benign epidermal cysts among cutaneous lesions, with a noteworthy representation of cutaneous malignancies. The findings highlight the crucial role of histopathology in accurate diagnosis, subclassification, and management planning. Establishing clinicopathological correlations can aid in early detection, particularly of malignant or atypical variants, thus optimizing patient care.
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References
1. Shilpa V, Mandakini T. Histopathological study of tumours of epidermis and epidermal appendages. Indian J Pathol Res Pract. 2017 Apr-Jun;6(2):460-6. doi: 10.21088/ijprp.2278.148x.62(pt-ii)
2. Sabir F, Aziz M, Afroz N, Amin SS. Clinical and cyto-histopathological evaluation of skin lesions with special reference to bullous lesions. Indian J Pathol Microbiol. 2010 Jan-Mar;53(1):41-6. doi: 10.4103/0377- 4929.59181, PMID 20090220
3. Chuong CM, Nickoloff BJ, Elias PM, Goldsmith LA, Macher E, Maderson PA, et al. What is the “true” function of skin? Exp Dermatol. 2002 Apr;11(2):159-87. doi: 10.1034/j.1600-0625.2002.00112.x. PMID 11994143, PMCID PMC7010069
4. Nigam JS, Bharti JN, Nair V, Gargade CB, Deshpande AH, Dey B, et al. Epidermal cysts: A clinicopathological analysis with emphasis on unusual findings. Int J Trichology. 2017 Jul-Sep;9(3):108-12. doi: 10.4103/ijt.ijt_16_17, PMID 28932061, PMCID PMC5596644
5. Inbasekaran DP, Ramachandran DT, Sivadharshini SJ, Murugan DR. Cutaneous cystic lesions: Its clinicopathological correlation with emphasis on unusual findings. Trop J Pathol Microbiol. 2021;7(3):135-43. doi: 10.17511/jopm.2021.i03.07
6. Marks R, Knight A, Laidler P. Benign epidermal tumours and cysts. In: Atlas of Skin Pathology. Current Histopathology. Vol. 11. Dordrecht: Springer; 1986. doi: 10.1007/978-94-009-4127-4_15
7. van Engen-van Grunsven AC, Kusters-Vandevelde H, Groenen Patricia PJ, Blokx Willeke WA. Update on molecular pathology of cutaneous melanocytic lesions: What is new in diagnosis and molecular testing for treatment? Front Med (Lausanne). 2014;1:39. doi: 10.3389/ fmed.2014.00039, PMID 25593912
8. Yamaguchi Y, Hearing VJ. Melanocytes and their diseases. Cold Spring Harb Perspect Med. 2014 May 1;4(5):a017046. doi: 10.1101/ cshperspect.a017046, PMID 24789876, PMCID PMC3996377
9. Guo A, Liu X, Li H, Cheng W, Song Y. The global, regional, national burden of cutaneous squamous cell carcinoma (1990- 2019) and predictions to 2035. Eur J Cancer Care. 2023;2023:1-8. doi: 10.1155/2023/5484597
10. Supekar BB, Tomar SS, Wankhade VH, Bhushan R, Singh RP, Bhat DM. Clinical spectrum of cutaneous malignancies in Central India: A retrospective study. Indian J Dermatol. 2021 May-Jun;66(3):284-90. doi: 10.4103/ijd.IJD_543_19, PMID 34446952, PMCID PMC8375545
11. Gandhi R, Vijayaraghavan S. Histopathological evaluation of tumours and cysts of the epidermis and dermal adnexae in a tertiary Care Hospital. Ann Pathol Lab Med. 2018 Jun 22;5(6):A533-9. doi: 10.21276/APALM.1990
12. Chughtai A, Hashim MM, Saleem R, Zafar G, Yasin R, Chughtai O, et al. Benign cutaneous cysts: A comprehensive analysis of 1160 cases. Cureus. 2023 Sep 19;15(9):e45548. doi: 10.7759/cureus.45548, PMID 37868536, PMCID PMC10586350
13. Roh NK, Hahn HJ, Lee YW, Choe YB, Ahn KJ. Clinical and histopathological investigation of seborrheic keratosis. Ann Dermatol. 2016 Apr;28(2):152-8. doi: 10.5021/ad.2016.28.2.152. PMID 27081260, PMCID PMC4828376
14. Kwon OS, Hwang EJ, Bae JH, Park HE, Lee JC, Youn JI, et al. Seborrheic keratosis in the Korean males: Causative role of sunlight. Photodermatol Photoimmunol Photomed. 2003;19(2):73-80. doi: 10.1034/j.1600-0781.2003.00025.x, PMID 12945806
15. Koyuncuer A. Histopathological evaluation of non-melanoma skin cancer. World J Surg Oncol. 2014;12:159. doi: 10.1186/1477-7819- 12-159. PMID 24886534
16. Chauhan K, Jassal V, Sara GK, Bansal V, Hatwal V. Histopathological study of verrucous lesions and its mimics. J Microsc Ultrastruct. 2021 May 27;9(2):86-97. doi: 10.4103/JMAU.JMAU_47_19, PMID 34350105, PMCID PMC8291099
17. Kheshvadjian AR, Erickson C, Calame A, Cohen PR, Erickson CP. Cutaneous horn revisited: A woman with a verruca vulgaris-associated cornu cutaneum. Cureus. 2021 Nov 26;13(11):e19925. doi: 10.7759/ cureus.19925, PMID 34976525
18. Cohen PR. Cornu cutaneum: Case reports of patients with a cutaneous horn associated with either a verruca vulgaris or an inverted follicular keratosis and a review of the etiologies of cutaneous horns. Cureus. 2023 Oct 9;15(10):e46747. doi: 10.7759/cureus.46747, PMID 38022343
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Copyright (c) 2025 Dr Shinitha IR, Dr Shobana B, Dr Srismitha S, Dr S Mary Lilly

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