Histopathological spectrum and clinicopathological concordance of papulosquamous lesions

Dermatologic diseases are prevalent worldwide, with varying prevalence. Papulosquamous lesions, characterized by scaly papules and plaques, often pose diagnostic challenges due to overlapping clinical presentations. Accurate histological diagnosis is essential for effective treatment. This prospective study was conducted at the Surgical Pathology Section, from January 2023 to April 2024, following ethical clearance in January 2023. Methods: Skin punch biopsy specimens from 81 clinically diagnosed/suspected papulosquamous skin diseases were analyzed. The specimens underwent formalin fixation, paraffin embedding, and haematoxylin-eosin staining. Histopathological findings were correlated with clinical diagnoses. Statistical analysis: Baseline demographic characteristics were analyzed using descriptive statistics (mean, frequency). Data analysis was performed using STATA 14.2. Results: Among 71 cases (meeting criteria), the most affected age group was > 60 years (25.35%), with a Male: Female ratio of 1.04:1 of 41 histopathologically diagnosed cases, Psoriasis and Lichen planus each accounted for 14 cases, followed by Lupus erythematosus and Pityriasis lichenoids (5 each). Concordance between clinical and histopathological diagnoses was 58%; discordance was 42%, including cases like chronic dermatitis and Drug-induced lichenoid rashes. Ten cases were inconclusive. Conclusion: Histopathological examination and clinical correlation are crucial for diagnosing papulosquamous diseases. Detailed clinical data enhances diagnostic accuracy, guiding disease-specific treatments.