title: Clinico-Histopathological Spectrum of Infectious Granulomatous Dermatoses in Western India- A Representative Study from Mumbai.
abstract: BACKGROUND
  Infectious Granulomatous Dermatoses (IGDS) have various aetiological factors with a considerable overlap in the histopathological and clinical features, thus posing a diagnostic dilemma for dermatologists and pathologists.
  
  
  OBJECTIVE
  We aimed at determining the histopathological profile of IGDS correlating it with clinical features with an attempt to find the aetiology.
  
  
  METHODS
  In a cross-sectional study conducted in a tertiary referral center of Mumbai over two years, out of 1872 skin biopsies received, 239 histopathologically diagnosed cases of IGDS were studied for histopathological features of granuloma. A clinico-histopathological correlation was attempted. Chi-square test was used for comparison of proportions of different groups.
  
  
  RESULTS
  Leprosy (211 cases) and tuberculosis (28 cases) were the commonest histopathologically diagnosed IGDS. Leprosy spectrum included BT (30.33% cases), followed by TT (21.32%), BL and LL and 21.79% cases of lepra reactions. Skin TB biopsies on histopathology showed lupus vulgaris (53.85% cases), scrofuloderma (15.38%), TBVC and papulonecrotic tuberculid (11.54% each). In leprosy maximum clinico-pathological agreement was seen at tuberculoid pole (TT 72.7% and BT 56.6%). Among tuberculosis cases, scrofuloderma (100%) and lupus vulgaris (53.8%) showed maximum agreement.
  
  
  CONCLUSIONS
  Leprosy and skin TB are the commonest IGDS in Mumbai region though difficult to diagnose and subcategorize with certainty during initial stages. Histopathology plays the important role to elucidate the dilemma. This being a single center study, more such studies with a larger sample size are recommended to get more elaborate data and regional prevalence of these IGDS for a better overall approach to prevention, treatment and control.
authors.affiliation: Assistant Professor, Department of Pathology, Dayanand Medical College & Hospital , Ludhiana, Punjab, India .
authors.forename: Sumit
authors.initials: S
authors.lastname: Grover
authors.affiliation: Associate Professor, Department of Pathology, Govt. Grant Medical College , Mumbai, India .
authors.forename: Shubhangi Vinayak
authors.initials: SV
authors.lastname: Agale
authors.affiliation: Professor and Head, Department of Pathology, Swami Ramanand Tirth Rural Govt. Medical College , Ambajogai, India .
authors.forename: Grace F
authors.initials: GF
authors.lastname: D'Costa
authors.affiliation: Professor and Head, Department of Pathology, Govt. Grant Medical College , Mumbai, India .
authors.forename: Arvind G
authors.initials: AG
authors.lastname: Valand
authors.affiliation: Assistant Professor, Department of Community Medicine, Dayanand Medical College & Hospital , Ludhiana, Punjab, India .
authors.forename: Vikram Kumar
authors.initials: VK
authors.lastname: Gupta
keywords: Leprosy; Lupus vulgaris; Scrofuloderma; Tuberculosis