Skin Biopsies in Practice: Insights from a Pediatric Dermatopathology Study in a Greek Tertiary Center

Pediatric dermatologic conditions often present with overlapping clinical features, complicating accurate diagnosis and potentially delaying appropriate treatment. This retrospective study aimed to evaluate the diagnostic utility of pediatric skin biopsies by assessing clinicopathologic concordance and identifying cases in which histopathologic analysis led to diagnostic reclassification. Medical records of 140 children (≤14 years) who underwent skin biopsy at a tertiary-care center in Greece between February 2021 and November 2024 were retrospectively reviewed. Most biopsies (126/140, 90.0%) were performed for diagnostic or therapeutic purposes, while 14/140 (10.0%) were cosmetic. The most common histologic diagnoses were tumors and cysts (63/140, 45.0%), dermatitis (38/140, 27.1%), and nevi (14/140, 10.0%). Clinicopathologic concordance was observed in 125/140 cases (89.3%), whereas diagnostic reclassification occurred in 15/140 cases (10.7%), most frequently involving pityriasis lichenoides et varioliformis acuta, lupus profundus, infantile facial aseptic granuloma, and lymphomatoid papulosis. These findings underscore the diagnostic value of pediatric skin biopsies and support their earlier and more systematic integration into pediatric dermatologic care to enhance diagnostic accuracy and improve clinical outcomes.