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Year : 2017  |  Volume : 31  |  Issue : 1  |  Page : 37-42

Noninfectious granulomatous dermatoses: A puzzle for dermatologists and histopathologists

1 Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
2 Department of Pathology, Grant Government Medical College, Mumbai, India
3 Department of Pathology, Swami Ramanand Tirth Rural Government Medical College, Ambajogai, Maharashtra, India

Correspondence Address:
Sumit Grover
Department of Pathology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana - 141 001, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-4958.198444

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Background: Noninfectious granulomatous dermatoses (NGDSs) are a broad group of distinct reactive inflammatory conditions that share clinical as well as histological similarities. Because of these similarities, these lesions pose a diagnostic difficulty to naοve and even expert dermatologists and pathologists and need a clinicopathological correlation. Aims and Objectives: We aimed at determining the histopathological profile of NGDS in Western Indian population correlating it with morphology, age, and anatomic distribution with an attempt to find the etiology. Materials and Methods: In a prospective study conducted over 2 years in a tertiary care referral center in Mumbai, out of 1872 skin biopsies received, 29 histopathologically diagnosed cases of NGDS were selected and studied for histopathological features of granuloma. A clinico-histopathological correlation was attempted. Results: Out of the total 1872 skin biopsies received in our department in 2 year period, 29 biopsies were histopathologically diagnosed as NGDS of which necrobiotic granulomas (n = 14) were the most common diagnosis which included granuloma annulare (78.57%), necrobiosis lipoidica (14.29%), and rheumatoid nodule (7.14%). Other frequently diagnosed lesions were sarcoidosis (13.79%), actinic granuloma (10.34%), erythema nodosum (6.89%), and erythema induratum (3.44%). Conclusions: Various NGDS exhibit histopathological features with considerable overlap. However, their knowledge is must to understand the clinical behavior. Similarly, detailed clinical history and examination of early and mature lesions help in differentiating between lesions sharing similar histological features.

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