Morphological study of different granulomatous lesions of the skin

Abstract

Objective Morphological study of different granulomatous lesions of the skin to determine the relative frequencies and to compare our results with those of other workers.Materials and methods A total of 2682 skin biopsies received over a period of 5 years from January, 2001 to December, 2005 at the department of Pathology, Basic Medical Sciences Institute, JPMC, Karachi, were reviewed.Results Out of a total of 2682 skin biopsies 123 cases were found to have a granulomatous reaction pattern. Out of them, tuberculoid granulomas were seen in 114 cases, foreign body type in 4 and suppurative and sarcoidal each in 2 cases. One case was of necrobiotic granuloma. Cutaneous tuberculosis was the most common lesion (97/123). 47 cases were typified. Out of them 18 were lupus vulgaris, 9 tuberculosis verrucosa cutis, 7 each of tuberculosis cutis orificialis and scrofuloderma and 6 were tuberculous gummas. AFB were seen in 20 out of 79 (25.31%) caseating, and 1 out of 35 (2.85%) non-caseating tuberculoid granulomas.Conclusion Granulomatous lesions of skin are more common in females. The most common type of granulomas is tuberculoid. The most common lesion in our study was tuberculosis (The incidence is 3.69% of all dermatology patients). The most common subtype of tuberculosis was lupus vulgaris (38.29%) followed by tuberculosis verrucosa cutis and scrofuloderma. AFB is more commonly seen in caseating granulomas.