Clinico pathological correlation of inflammatory palmoplantar dermatoses in a tertiary care hospital

Bhupathi Sharanya; Rajendran Narayanan; Srikanth Shanmugam; Manobalan Karunanandhan; Shanmugasamy Kathirvelu

doi:10.18203/issn.2455-4529.IntJResDermatol20263737

Authors

Bhupathi Sharanya Department of of Dermatology Venereology and Leprosy, Mahatma Gandhi Medical College and Research Institute, SBV University, Pondicherry, India
Rajendran Narayanan Department of of Dermatology Venereology and Leprosy, Mahatma Gandhi Medical College and Research Institute, SBV University, Pondicherry, India
Srikanth Shanmugam Department of of Dermatology Venereology and Leprosy, Mahatma Gandhi Medical College and Research Institute, SBV University, Pondicherry, India
Manobalan Karunanandhan Department of of Dermatology Venereology and Leprosy, Mahatma Gandhi Medical College and Research Institute, SBV University, Pondicherry, India
Shanmugasamy Kathirvelu Department of Pathology, Mahatma Gandhi Medical College and Research Institute, SBV University, Pondicherry, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20263737

Keywords:

Clinical, Histopathology, Correlation, Palmoplantar dermatoses, Inflammatory dermatoses

Abstract

Background: Inflammatory palmoplantar dermatoses (PPD), including palmoplantar psoriasis, palmoplantar pustulosis, palmoplantar eczema, palmoplantar lichen planus, lichen nitidus often mimics each other, posing a diagnostic challenge. This study was done in an attempt to identify the clinicopathological correlation of these conditions as they have an impact on the patient's quality of life. To arrive at the degree of concordance between clinical and histopathological diagnosis of inflammatory PPD.

Methods: A 15-month study (February 2018–April 2019) was done in the Department of Dermatology, Mahatma Gandhi Medical College and Research Institute, Pondicherry. Forty patients with clinically doubtful inflammatory PPD or responding poorly to treatment underwent clinical examination and lesional skin biopsy. Clinical and histopathological diagnoses were correlated.

Results: The mean age in 40 patients was 50.60 (SD=16.46) years. Psoriasis was the most common diagnosis clinically (22, 55%) and histopathologically (23, 57.5%), followed by eczema (10, 25% and 9, 22.5%) respectively. clinicopathological concordance was observed in 18 (82%) patients with psoriasis, 6 (60%) eczema, 1 (16.7%) lichen planus and 1 (100%) patient with pustulosis. It was statistically significant in psoriasis (p=0.035), eczema (p=0.03) and pustulosis (p<0.0001), but not for lichen planus and lichen nitidus. In the non-concordant group, histopathology showed nonspecific dermatitis in 6 (15%) patients.

Conclusions: Although skin biopsy did not offer a specific diagnosis in the non-concordant group, it contributed in establishing the diagnosis in the concordant group. Hence, clinicopathological correlation is valuable for establishing an accurate diagnosis and guiding appropriate treatment.

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