Clinicopathological Correlate of Papulosquamous Skin Disorder in a Tertiary Health Care

Abstract

Papulosquamous skin disorder is one of the frequently seen skin dermatoses; but due to clinical and morphological overlap, it is sometimes difficult to make a straight forward clinical diagnosis without histological confirmation. This study seeks to examine the level of correlation between clinical diagnosis and histological confirmation. Medical records of subjects diagnosed at the Dermatology clinic with papulosquamous skin disorder between January 2017 and December 2019 were retrieved. Their bio data, clinical description of their lesions, clinical diagnosis and histopathological report were noted and analyzed with SPSS version 23 of the 88 patients with clinical diagnosis of a papulosquamous skin disease, 62 had record of skin biopsy result; these were included in the data analysis. The mean age was 39.1± 13.8 years (age ranged from 3-64 years). Ratio of male to female was 1.7:1 Thirty-four 34 (54.8%) were clinically diagnosed as lichen planus, 25 (40.3%) as psoriasis, 1(1.6%) each as parapsoriasis, lichen nitidus and lichen simplex chronicus. Histopathological diagnosis was the same in 26 cases of lichen planus, 19 of psoriasis and for the above mentioned disorders. Common histological findings for lichen planus were acanthosis 88.5%, hyperkeratosis (30.8%), parakeratosis (3.8%), papillomatosis (61.5%), hypergranulosis (3.8%) and band-like lymphocytic infiltrate (57.7%). While acanthosis (68.4%), Elongated rete ridges (84.2%); band-like lymphocytic infiltrate (78.9%) and dermal dilated blood vessels (5.3%) were seen in psoriasis. In conclusion: We observed 77.4% accuracy in diagnosis of papulosquamous skin disorder.