# Skin Biopsies in Practice: Insights from a Pediatric Dermatopathology Study in a Greek Tertiary Center

## TL;DR

This study shows that skin biopsies in children help diagnose complex skin conditions accurately and can change initial diagnoses, improving treatment decisions.

## Contribution

The study provides insights into the diagnostic utility of skin biopsies in pediatric dermatology through a retrospective analysis in a Greek tertiary center.

## Key findings

- Most pediatric skin biopsies were performed for diagnostic or therapeutic reasons.
- Diagnostic reclassification occurred in 10.7% of cases, including conditions like pityriasis lichenoides and lupus profundus.
- High clinicopathologic concordance (89.3%) highlights the value of histopathologic analysis in pediatric dermatology.

## Abstract

Pediatric dermatologic conditions often present with overlapping clinical features, complicating accurate diagnosis and potentially delaying appropriate treatment. This retrospective study aimed to evaluate the diagnostic utility of pediatric skin biopsies by assessing clinicopathologic concordance and identifying cases in which histopathologic analysis led to diagnostic reclassification. Medical records of 140 children (≤14 years) who underwent skin biopsy at a tertiary-care center in Greece between February 2021 and November 2024 were retrospectively reviewed. Most biopsies (126/140, 90.0%) were performed for diagnostic or therapeutic purposes, while 14/140 (10.0%) were cosmetic. The most common histologic diagnoses were tumors and cysts (63/140, 45.0%), dermatitis (38/140, 27.1%), and nevi (14/140, 10.0%). Clinicopathologic concordance was observed in 125/140 cases (89.3%), whereas diagnostic reclassification occurred in 15/140 cases (10.7%), most frequently involving pityriasis lichenoides et varioliformis acuta, lupus profundus, infantile facial aseptic granuloma, and lymphomatoid papulosis. These findings underscore the diagnostic value of pediatric skin biopsies and support their earlier and more systematic integration into pediatric dermatologic care to enhance diagnostic accuracy and improve clinical outcomes.