Clinical and histopathological correlation in genital mucosal lesions: A prospective cross-sectional study from Western India

Abstract Introduction: Genital mucosal lesions encompass a diverse spectrum of infectious, inflammatory, and neoplastic conditions and go beyond sexually transmitted infections. Accurate clinical diagnosis can be challenging due to anatomical location, overlapping presentations, and secondary changes. Histopathological examination remains a crucial tool to establish the definitive diagnosis and guide management. Aim: To study the clinical patterns of genital mucosal lesions other than STIs and analyse the correlation between clinical diagnosis and histopathological findings. Settings and Design: Cross sectional study; Department of Dermatology in a tertiary care teaching hospital. Subjects and Methods: A prospective cross-sectional study was conducted from July 2022 to January 2024 at a tertiary care hospital. A total of 27 patients presenting with genital mucosal lesions were included. Detailed history, clinical examination, and biopsy of the lesions were performed. Clinical and histopathological diagnoses were compared to assess correlation. Results: Among the 27 patients, males were more frequently affected (63%) than females (37%), with the most common age group being 31–40 years (33.3%). The most frequently observed clinical diagnoses included genital lichen planus (LP) (25.9%), LSCA (14.8%), and squamous cell carcinoma (SCC) (14.8%). Clinicopathological concordance was observed in 66.7% of cases. The highest correlation was seen in inflammatory disorders such as LP and lichen sclerosus, while lower correlation was noted in premalignant and malignant lesions including SCC and erythroplasia of Queyrat. Conclusions: A moderate clinicopathological correlation was observed in genital mucosal lesions, particularly among inflammatory dermatoses. Biopsy remains essential in confirming diagnosis and identifying cases with atypical or misleading features.