Skin Biopsy and Histopathological Diagnosis of Dermatological Diseases

Microscopic examination of skin and mucous membrane is an established investigation in diagnosis and follow up of many dermatological conditions frequently encountered during practice. Histopathological examination is performed with biopsied specimen from skin and or mucous membrane where required. However neither do all skin biopsies produce neither a conclusive diagnosis nor the dermatologists routinely perform this procedure to every patient they consult. This cross sectional descriptive study conducted by reviewing the records of all biopsied cases studied for histopathology in Mymensingh Medical College, Mymensingh and Shaheed Mansur Ali Medical College, Dhaka, Bangladesh from January 2012 to December 2016. The aim of this study was to investigate the favourable clinical diagnoses set by dermatologists when performing skin biopsy, the diagnoses reached by the dermatopathologists after microscopic examination, and the relationship between them and finally to comment on the instances that skin biopsy fails to fulfill the diagnostic task. Fourteen hundred and thirty six (1436) cases of skin biopsy were reviewed and descriptive statistics were performed. Maximum cases 39.1% (562) were in 2nd decade with almost equal sex distribution. The most frequently proposed clinical diagnoses included papulosquamous dermatoses 28.6% (410), whereas histological confirmation was in 13.1% (188). Histological diagnosis was more as nonspecific dermatitis 31.6% (454). After microscopic examination, a specific histological diagnosis was found in 83.5% (1199) of the cases and a consensus between clinical and histological diagnoses was observed in 69.2% (994). Neither histological diagnosis nor any feature consistent with clinical suspicion was observed in 10.1% (145) cases. Histopathological examination of skin biopsy is still a valuable diagnostic tool in many skin diseases and dermatoses with diagnostic dilemma. There are cases in which diagnostic inefficiency are being faced even after skin biopsy examination.