Clinicopathological Compatibility Rates with Regard to Skin Punch Biopsies

The aim of this study was to explore the compatibility of clinical prediagnosis and histopathological diagnosis of skin punch biopsies at the Pathology Department of Ankara Atatürk Training and Research Hospital, Yýldýrým Beyazýt University, Turkey. Several factors may change the appearance of a typical lesion because the skin is open to the external environment, and clinical diagnoses may be difficult. As a result, the histopathological assessment of skin punch biopsies and the support given by clinicians to the pathologist are extremely important.
Whole punch biopsy diagnoses, which were evaluated at the department between the years 2006 and 2015, were grouped according to the inflammatory reaction patterns determined and described in Weedon’s Textbook of Dermatopathology. Subsequently, the compatibility rates of clinical prediagnosis were studied, focusing especially on the first three prediagnoses. A total of 2967 punch biopsies were evaluated at the department between the years 2006 and 2015; 93.09% were diagnosed with inflammatory dermatosis, and 6.9% with tumors. The compatibility rate between clinical prediagnosis and pathological diagnosis was 85.77%; 65.75% of the cases were compatible with the first three prediagnoses. The compatibility rate of inflammatory dermatosis was 93.09%.The most common compatibility with prediagnosis was seen in epidermal maturation and keratinization and elastic tissue lesions with a rate of 100%.
Although performing a skin biopsy is easy, histopathological evaluation of the skin has not been used commonly. In fact, it is recommended that skin biopsy should be performed in cases with possible neoplasia, bullous diseases, or dermatosis, which have not been clinically diagnosed. In these cases, clinicopathological correlation is important to reach a true diagnosis. This study aimed to determine mutual contributions of clinicians and pathologists by evaluating clinicopathological compatibility rates.