CONSISTENCY BETWEEN CLINICAL AND PATHOLOGICAL DIAGNOSIS OF SKIN DISEASES FROM SKIN BIOPSY DONE IN SPHMMC DERMATOVENEROLOGY OPD

Abstract

BACKGROUND: Histopathology is the gold standard diagnostic tool for diagnosing skin disorders in addition to history and physical examination. The interpretation of a skin biopsy requires Clinicopathological correlation and the most accurate diagnosis is the one that most closely correlates with the clinical features and helps in planning the most appropriate clinical intervention. OBJECTIVE: To determine the consistency between clinical and histopathological diagnosis of skin disease from skin biopsies done in SPHMMC Dermatovenerology OPD and to identify the factors affecting the correlation. METHOD: Retrospective cross-sectional study of histopathology request form and final pathology result from skin biopsy done in Dermatovenerology OPD in SPHMMC from September 2019 to August 2022 was done. The total skin biopsy done over this period is 260. The collected data was edited, coded and entered in to SPSS version 21.0 software for analysis. The level of statistical significance was at P < 0.05. Results are summarized and presented by tables, texts and graphs. RESULT: A total of 220 histopathologic request form and their results were analyzed to assess the correlation between clinical and histopathological diagnosis. 49.1% were definitive consistent, 27.7% descriptive consistent, 12.3% definitive inconsistent and 10.9% were descriptive inconsistent. There was high rate of clinicopathological correlation in sufficiently filled request forms (AOR: 3.779, 95 % CI: 1.709 – 8.356) and in some disease conditions like vesiculobullous (AOR: 12.553, 95 % CI: 1.185 – 132.843) and malignancy (AOR: 8.48, 95 % CI: 1.793 – 40.094). No correlation was observed with clinicopathologic consistency and biopsy type, number of differential diagnosis, disease duration and site of biopsy. CONCLUSION: The consistency between clinical and histopathological diagnosis in this study was found to be 76.8%. The adequacy of the clinical information provided to the pathologist and the type of the disease was found to affect the correlation KEY WORDS: Dermatopathology, Skin biopsy, Clinicopathological consistency