THE STUDY ON CLINICOPATHOLOGICAL CORRELATION OF EPIDERMAL LESIONS IN A TERTIARY CARE CENTER – A GAMUT OF NON-NEOPLASTIC TO MALIGNANT LESIONS

Objectives: This study aimed to analyze the histopathological spectrum of epidermal lesions and correlate them with age, gender, and site, highlighting histopathology’s essential role in accurate cutaneous lesion diagnosis. Methods: This combined prospective and retrospective study was conducted over 2 years in the pathology department of a tertiary care hospital. A total of 182 skin specimens were examined using hematoxylin and eosin staining, with special stains when needed. Clinical data were collected, and cases were histologically classified and statistically analyzed using IBM SPSS Version 24. Results: The most prevalent category was epidermal cysts, comprising 65.39% of all lesions (119/182), with keratinous epidermal type cysts (41.2%) being the most common subtype. These were frequently seen on the back and face. Other cystic variants included pilar cysts, dermoid cysts, steatocystomas, and infected cysts with abscess formation. Cutaneous malignancies represented 11.54% of cases (21/182), including squamous cell carcinoma, verrucous carcinoma, and five histological variants of basal cell carcinoma, predominantly located on sun-exposed areas such as the face. Benign tumor-like lesions included seborrheic keratosis (7.14%), fibroepithelial polyps (5.49%), verrucous lesions (4.39%), melanocytic nevi (3.85%), and Bowen’s disease (2.19%). Lesions were most common in the 41–50-year age group (23.63%), and females were slightly more affected (M:F ratio 1:1.09). The head and neck region (35.16%) and back (25.82%) were the most common anatomical sites. Conclusion: This study emphasizes the predominance of benign epidermal cysts among cutaneous lesions, with a noteworthy representation of cutaneous malignancies. The findings highlight the crucial role of histopathology in accurate diagnosis, subclassification, and management planning. Establishing clinicopathological correlations can aid in early detection, particularly of malignant or atypical variants, thus optimizing patient care.