HISTOMORPHOLOGICAL CHARACTERISATION OF NON-SPECIFIC DERMATITIS ON SKIN BIOPSIES ANALYSED IN A TERTIARY CARE CENTRE.

Abstract

Histopathologic examination of skin biopsies is very crucial in the clinical dermatology. A need for pattern categorization of non-specific dermatitis is an important step in the algorithmic approach of inflammatory dermatosis. Histopathological diagnosis is based on clinical correlation but many times there is discordance between morphological findings and clinical diagnosis leading to descriptive reporting. Such reporting is often of little help to the dermatologist. Hence there is a need to look into these non-specific morphological groups so that a criteria/ algorithm could be developed to give a definitive diagnosis. A one year retrospective study was done in department of pathology, school of medical science and research. A total of 62 cases H&E slides were examined by two pathologist and the categories which were non-specific were labelled as study group. The study group included 32 cases were reclassified into predominant inflammatory reaction pattern i.e spongiotic, interface, psoriasiform, lichenoid to reclassify this group. Out of the total 62 skin biopsies, 32 (52%) cases were non-specific and the most common histopathological features with non-specific dermatitis cases were mild degree of spongiosis (44%), compact orthokeratosis (37.5%), acanthosis (56.3%), dermal interface vacuolisation (47%) and most common distribution of dermal infiltrate were superficial (66%). Most common pattern of dermatitis was spongiotic (65.6%) followed by lichenoid pattern (15.6%).

Morphological categorisation of non-specific dermatitis under spongiotic, interface, psoriasiform or lichenoid according to the pattern of distribution is much more informative than giving a purely descriptive reporting. A clinicopathological correlation becomes much easier and relevant for the dermatologist.