Iraqi Postgraduate Medical Journal

Abstract

BACKGROUND:
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.
OBJECTIVE:
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.
RESULTS:
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.
CONCLUSION:
Clinicopathological