Facial granulomatous dermatoses: A clinico-pathological study

Background: Granulomatous dermatoses frequently present a diagnostic challenge as an identical histologic pattern may be produced by several causes, and conversely, a single cause may produce several histologic patterns. The present study aims at diagnosing facial granulomatous dermatoses based on combination of clinical and histopathological features and evaluating their correlation. Methods: Archival records were retrieved and clinically suspected and/or histopathologically diagnosed facial granulomatous dermatoses cases were taken as study material. Clinical and histopathological data was tabulated and concordance rate was calculated. Results: Out of 832 skin biopsies, 64 were from face and 18 were of facial granulomatous dermatoses. Age ranged 13–55 years with male to female ratio 1.6:1. Majority (88%) were of infectious etiology, leprosy being maximum i.e. 10/18 cases (55%) and borderline tuberculoid outnumbered all other categories with 7/10 cases (70%). Histopathologically, 14 cases (77.78%) had epithelioid granulomas and two each of histiocytic and mixed inflammatory type. Ziehl–Neelsen stain was positive in three cases (16.67%). Overall clinico-pathological concordance rate was 61.11% with 77.77% concordance for leprosy cases.