Demographic and morphological analysis of granulomatous dermatoses

Introduction: Granulomatous reaction is chronic inflammatory pattern which is characterized by presence of granulomas. Many of the skin granulomatous conditions produce identical pattern and hence it remains always a diagnostic challenge to pathologist. Arrival at the accurate diagnosis is of great interest so that appropriate treatment can be ensured. Aim: To study different morphological patterns of granulomatous lesions of the skin along with the etiology and demographic pattern. Materials and Methods: All the skin biopsies with the histological features of granulomatous disease received in the Pathology Department, Father Muller Medical College for a period of three and half years (Jan 2009 to May 2012) are included in the study. The clinical details and H and E sections of all the cases were reviewed. Results: Of 75 cases of skin biopsies with granulomatous lesions, 65 (85%) were found in males. Out of these, Tuberculoid type of granulomas was seen in 57 cases (76%), suppurative type in 10 cases (13.4%), Necrobiotic type in 4(5.3%) cases and foreign body type in 4(5.3%) cases. Sixty five cases (86%) were infectious granulomatous lesions. Leprosy was amounting to 49 cases (65%), followed by tuberculosis and chromoblastomycosis with each of 8 cases. Other causes were foriegn body granuloma, necrobiosis lipoidica and granuloma annulare. Conclusion: Males are more commonly affected by granulomatous dermatosis. In this study, tuberculoid granulomas were the most common type. The most common cause of granulomatous skin lesion was leprosy. Other common cases were tuberculosis and chromoblastomycosis.