Non-Neoplastic Lesions of Skin - A Histopathological Study on Punch Biopsy

Introduction: India with diverse population groups having different customs, thus offering the perfect backdrop for a wide variety of peculiar and distinctive dermatosis. Skin is the largest external organ of the body accounting for 16-20% of the total body weight.8 The pattern of skin diseases varies from one country to another country and across different parts in the same country. Though the spectrum of histopathology of skin disorders is varied, clinical presentation is restricted to only a few changes such as hyperpigmentation, hypopigmentation, macules, papules, nodules and a few others.9 Each clinical presentation is common to different histopathological pictures and thus definitely require histopathology for their confirmation. Aims and Objectives: 1) To study the incidence of various Non-neoplastic lesions of skin. 2) To study the age and sex wise distribution of Non-neoplastic skin lesions. 3) To study the morphological patterns of Non-neoplastic skin lesions. Materials and Methods: The present study comprised of a total 400 punch biopsy specimens of skin lesions and studied over a consecutive period of about 2 years and 4 months (June 2017 to October 2019) in a tertiary care centre Ahmedabad, Gujarat. All the tiny punch biopsy bits, poorly preserved tissue bits and cases with clinical impression of neoplastic etiology were excluded from the study. Descriptive cross-sectional study of cases including detailed clinical data of age, sex, clinical features, and type of lesion of patients was obtained. The data was retrieved from computerised software laboratory information system (LIS). Results: In the study, maximum number of cases were observed in the age group of 21-30 years with 22.25% of total cases (male=57 and female=32) and Male: Female ratio is 1.58:1. Thus male is affected more than female and particularly after the age of 40. There were 26.5% cases of Non-infectious erythematous, papular and squamous diseases as well as of infectious diseases. Among non-infectious erythematous, papular and squamous lesions, 33.9% cases were of Lichen planus. Of all the infective lesions, Leprosy was the most common (62.2% of all infective lesions). Discussion: Skin biopsy is the most common diagnostic tests in dermatology. To achieve accurate and rapid diagnosis, it is important to incorporate clinical knowledge of the disease. Skin diseases in general population in various studies varies from 6.3% to 11.16%.The most common age group in the present study was 21-30 years with 22.25% of all the cases. Leprosy comprised maximum of 38 cases, largest number of cases were that of Borderline Tuberculoid type of leprosy (22 cases), followed by tuberculoid Leprosy. Conclusion: In the present study, wide spectrum of skin lesions, common and rare were observed. Leprosy is a still a disease of increasing frequency. Skin diseases are common in adult life third to fourth decade affecting males more than females. Vascular, viral, protozoan diseases are the rare lesions of skin.