# Retrospective study of histomorphological examination of skin lesion biopsies and their clinical concordance: experience from a tertiary care hospital in India

## TL;DR

This study examines how often skin biopsy results match clinical diagnoses, finding that histopathology is especially helpful for complex skin conditions.

## Contribution

The study provides empirical evidence on clinicopathological concordance rates in a diverse set of skin lesions in an Indian hospital setting.

## Key findings

- Inflammatory dermatitis was the most common diagnosis, followed by vesiculobullous diseases and benign keratinocytic/epidermal proliferation.
- Melanocytic lesions and vesiculobullous diseases showed the highest clinicopathological concordance rates at 100% and 85.71%, respectively.
- A significant association was found between the presence of clinical differential diagnoses and higher concordance with histopathological findings.

## Abstract

Histopathological examination is a cornerstone in dermatological diagnosis, providing critical insights into the pathogenesis and classification of cutaneous disorders. This study aims to evaluate the concordance between clinical diagnoses and histopathological findings in skin lesion biopsies. This descriptive cross-sectional retrospective study analyzed 321 skin biopsies performed in a dermatology outpatient department. Demographic data, clinical presentations, biopsy site locations, and histopathological findings were systematically recorded. Biopsies were categorized into 12 groups based on histopathological diagnosis, and clinicopathological concordance was assessed. The study included 321 cases (174 men, 147 women) aged 3 to 90 years. Inflammatory dermatitis was the most common diagnosis (39.87%), followed by vesiculobullous diseases (10.90%) and benign keratinocytic/epidermal proliferation (10.59%). The head region was the most frequent biopsy site (20.87%), and plaque formation (30.52%) was the predominant clinical presentation. Overall, clinicopathological concordance was observed in 72.6% of cases. Notably, higher concordance rates were found in melanocytic lesions (100%) and vesiculobullous diseases (85.71%). Chi-square analysis revealed a highly significant association (P < 0.001) between the presence of clinical differential diagnoses and concordance with histopathological findings. This study highlights the value of histopathological examination in confirming clinical diagnoses of dermatological conditions, particularly for complex cases. To enhance clinicopathological concordance, dermatologists should provide comprehensive clinical information and, where relevant, include differential diagnoses (D/D).