Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases

Introduction: Although textbooks provide the ideal clinical and histopathological findings, in practice we usually have fewer, and sometimes contradictory, findings to work with. Objectives: The primary goal of this study is to categorize the diagnoses of clinically challenging skin lesions, there...

Full description

Bibliographic Details
Main Authors: Yunus Ozcan, Emin Özlü, Ebru Karagün, Belkız Uyar, Mehmet Gamsızkan
Format: Article
Language:English
Published: Mattioli1885 2022-10-01
Series:Dermatology Practical & Conceptual
Subjects:
Online Access:https://www.dpcj.org/index.php/dpc/article/view/2239
_version_ 1811325481806462976
author Yunus Ozcan
Emin Özlü
Ebru Karagün
Belkız Uyar
Mehmet Gamsızkan
author_facet Yunus Ozcan
Emin Özlü
Ebru Karagün
Belkız Uyar
Mehmet Gamsızkan
author_sort Yunus Ozcan
collection DOAJ
description Introduction: Although textbooks provide the ideal clinical and histopathological findings, in practice we usually have fewer, and sometimes contradictory, findings to work with. Objectives: The primary goal of this study is to categorize the diagnoses of clinically challenging skin lesions, thereby identifying the most common diagnostic scenarios encountered by dermatopathologists in practice and the most perplexing differential diagnoses submitted by clinicians. Our secondary aim is to investigate how the case profile and clinician decision-making processes changed during the COVID-19 pandemic. Methods: We classified 2184 pathology reports into four major categories: inflammatory, neoplastic, non-diagnostic, and other. In each category, the three most frequently reported diagnoses were listed. For each listed diagnosis, the top 3 most frequently used differential diagnoses by the clinician prior to biopsy are listed. The period one year after and before the first nationally reported COVID-19 case was compared using the same classification. Results: The most common diagnoses and clinical differential diagnoses were listed for each category, with 45.4% being inflammatory and 27.4% being neoplastic diseases. Non-diagnostic reports accounted for 11.4% of all reports. The overall number of reports has decreased drastically since the pandemic, and the rates of keratinocytic and melanocytic neoplasms have increased, while the rates of other malignancies and spongiotic diseases have decreased. Conclusion: Although a trained eye can easily identify skin lesions when they are typical, even diseases we are familiar with can present atypically in real life. In these cases, histopathological examinations and clinicopathological correlation are critical in making an accurate diagnosis.
first_indexed 2024-04-13T14:33:55Z
format Article
id doaj.art-8fa6104f433b4bcfba8f4ac640492d81
institution Directory Open Access Journal
issn 2160-9381
language English
last_indexed 2024-04-13T14:33:55Z
publishDate 2022-10-01
publisher Mattioli1885
record_format Article
series Dermatology Practical & Conceptual
spelling doaj.art-8fa6104f433b4bcfba8f4ac640492d812022-12-22T02:43:05ZengMattioli1885Dermatology Practical & Conceptual2160-93812022-10-0112410.5826/dpc.1204a186Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 casesYunus Ozcan0Emin Özlü1Ebru Karagün2Belkız Uyar3Mehmet Gamsızkan4Department of Dermatology, Duzce University, Duzce, Turkey Department of Dermatology, Duzce University, Duzce, Turkey Department of Dermatology, Istinye University, Istanbul, Turkey Department of Dermatology, Duzce University, Duzce, Turkey Department of Dermatology, Duzce University, Duzce, Turkey Introduction: Although textbooks provide the ideal clinical and histopathological findings, in practice we usually have fewer, and sometimes contradictory, findings to work with. Objectives: The primary goal of this study is to categorize the diagnoses of clinically challenging skin lesions, thereby identifying the most common diagnostic scenarios encountered by dermatopathologists in practice and the most perplexing differential diagnoses submitted by clinicians. Our secondary aim is to investigate how the case profile and clinician decision-making processes changed during the COVID-19 pandemic. Methods: We classified 2184 pathology reports into four major categories: inflammatory, neoplastic, non-diagnostic, and other. In each category, the three most frequently reported diagnoses were listed. For each listed diagnosis, the top 3 most frequently used differential diagnoses by the clinician prior to biopsy are listed. The period one year after and before the first nationally reported COVID-19 case was compared using the same classification. Results: The most common diagnoses and clinical differential diagnoses were listed for each category, with 45.4% being inflammatory and 27.4% being neoplastic diseases. Non-diagnostic reports accounted for 11.4% of all reports. The overall number of reports has decreased drastically since the pandemic, and the rates of keratinocytic and melanocytic neoplasms have increased, while the rates of other malignancies and spongiotic diseases have decreased. Conclusion: Although a trained eye can easily identify skin lesions when they are typical, even diseases we are familiar with can present atypically in real life. In these cases, histopathological examinations and clinicopathological correlation are critical in making an accurate diagnosis. https://www.dpcj.org/index.php/dpc/article/view/2239DermatologyDermatopathologyClinicopathological correlationCOVID-19
spellingShingle Yunus Ozcan
Emin Özlü
Ebru Karagün
Belkız Uyar
Mehmet Gamsızkan
Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases
Dermatology Practical & Conceptual
Dermatology
Dermatopathology
Clinicopathological correlation
COVID-19
title Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases
title_full Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases
title_fullStr Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases
title_full_unstemmed Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases
title_short Dermatopathological Correlation of Clinically Challenging Cutaneous Lesions: A Single Center Experience of 2184 cases
title_sort dermatopathological correlation of clinically challenging cutaneous lesions a single center experience of 2184 cases
topic Dermatology
Dermatopathology
Clinicopathological correlation
COVID-19
url https://www.dpcj.org/index.php/dpc/article/view/2239
work_keys_str_mv AT yunusozcan dermatopathologicalcorrelationofclinicallychallengingcutaneouslesionsasinglecenterexperienceof2184cases
AT eminozlu dermatopathologicalcorrelationofclinicallychallengingcutaneouslesionsasinglecenterexperienceof2184cases
AT ebrukaragun dermatopathologicalcorrelationofclinicallychallengingcutaneouslesionsasinglecenterexperienceof2184cases
AT belkızuyar dermatopathologicalcorrelationofclinicallychallengingcutaneouslesionsasinglecenterexperienceof2184cases
AT mehmetgamsızkan dermatopathologicalcorrelationofclinicallychallengingcutaneouslesionsasinglecenterexperienceof2184cases