Clinicopathological Consistency in the Diagnosis of Skin Disorders in Patients Attending Dermatology Centre Medical City Teaching Hospital
Iraqi Postgraduate Medical Journal,
2019, Volume 18, Issue 3, Pages 218-226
Skin biopsy is often considered as confirmatory in case of diagnostic dilemma and is the most
common investigation sought by a dermatologist. Hence, a high diagnostic accuracy of this
investigation is pursued.
The study was planned to determine the consistency between the provisional clinical diagnosis of
skin diseases and the final diagnosis after clinicopathological correlation.
MATERIALS AND METHODS:
The study was carried out from the 1st of April 2017 to the 1st of April 2018 at dermatology center
Medical City Teaching Hospital. During this period, a total of 440 biopsies were performed, and
110 biopsies were reviewed at the clinicopatholgical meeting every Sunday. Interesting and difficult
cases were presented at the meeting and discussed to reach a final diagnosis. A comparison was
made between the provisional clinical diagnosis and the final diagnosis, and between the
histopathological report and the final diagnosis.
This study included 110 patients; of them, 65 patients were males (60%) and 45 patients (40%) were
females with the mean of age was 41.6±18.6 yrs. The most frequent conditions were tumors in 51
cases (46.36 %), pupulosquamous diseases 20 cases (18.18 %), infections 11 cases (10 %),
connective tissue diseases 7 cases(6.36 %), vescicobullous 7 cases (6.36 %), & miscellaneous
diseases 14 cases (12.72 %). Concerning tumors, 35 cases (68.63%) were malignant, and 16 cases
(31.37%) were benign. Of these tumours the most frequent tumour was mycosis fungoides; 9 cases
(17.6%), followed by squamous cell carcinoma; 5 cases (9.8%). Regarding the consistency
between provisional clinical diagnosis and the final diagnosis, the current study showed that 21
cases (19%) were consistent, 60 cases (55%) were corroborative, and 29 (26%) of the cases were
inconsistent. This study showed that there was a consistency between provisional clinical diagnoses
and histopathological report in 19 biopsies (17%), 75 biopsies (68%) were corroborative, and 16
biopsies (15%) were inconsistent.Concerning the consistency between histopathological report and
final diagnosis, 68 biopsies (62%) were consistent, while 42 biopsies (38 %) were inconsistent.
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