1Department of Pathology, S. Nijalingappa Medical college, Bagalkot-587101, Karnataka
2Department of Pathology, J J M Medical College, Davangere-577004
3Department of Dermatology, Karnataka Institute of Medical Sciences, Hubli
4Department of Pathology, Karnataka Institute of Medical Sciences, Hubli
5Department of Pathology, Karnataka Institute of Medical Sciences, Hubli
*Author for Correspondence Dr Jayashree. Pawale. Assistant professor of pathology. C-14 staff quarters, S. Nijalingappa Medical College, BAGALKOT- 587101. State - Karnataka. Mobil:09538161007 pawalejayashree@gmail.com
Online published on 1 October, 2011.
Background
Granulomatous dermatoses frequently present a diagnostic challenge to both pathologist and dermatologist. In order to treat these lesion, definitive diagnosis by demonstration of the etiological agent is essential, which will bear an impact on patient management and outcome.
Objective
The aim was to study the morphology and find the etiology of all the granulomatous lesions on histopathologically evaluated biopsies of the skin and subcutaneous tissue.
Materials and methods
Two year prospective study was done in KIMS; Hubli. The biopsies of the cases diagnosed as granuloma on H&E stained sections were selected. Special stains like Ziehl-Neelsen stain, Gomori's Methenamine silver, and Fite faraco were done wherever required.
Results
Total of 53 granulomatous lesions were studied. Granulomas with different morphology and etiology were seen. The most common morphological type of granuloma seen was tuberculoid granuloma with 20 cases followed by histiocytic granuloma with 14 cases, foreign body granuloma with 09 cases, suppurative granuloma with 08 cases and necrobiotic granuloma 02 cases.
Commonest etiology of granuloma was leprosy with 30 cases followed by foreign body granuloma, granulomas of fungal etiology, and granulomas of tuberculous etiology, actinomycosis and the granulomas of unknown etiology.
Conclusion
An attempt has to be made to put these granulomas into specific etiological and morphologic category for specific treatment. Granulomatous lesion of skin was most common lesion in males. Commonest type of granuloma was tuberculoid and the most common etiological subtype was borderline tuberculoid leprosy. Morphology of lesion and use of special stain helped us to diagnose with specific etiology for 51 out of 53 cases.
Granulomas, leprosy, fungal
