Clinicopathological Spectrum of Non-Neoplastic Lesions of Skin Punch Biopsies: A Retrospective Study

Abstract

Non-neoplastic skin lesions are more prevalent than neoplastic lesions. Clinically, many skin lesions exhibit overlapping morphological features, making correct diagnosis difficult without histopathological evaluation. A pattern-based approach to evaluation of skin punch biopsies facilitates categorization and diagnosis. Aim and Objectives: To analyze the clinical presentation, histopathological spectrum of non-neoplastic skin lesions and classify them based on tissue reaction patterns. Materials and Methods: This retrospective study was conducted over one year (JanuaryDecember 2025) in the Department of Pathology at a tertiary care center. Relevant clinical data were retrieved, histopathological slides were examined, diagnoses were established and categorized according to tissue reaction patterns. Findings were compiled and analyzed in Microsoft Excel. Results: A total of 88 skin punch biopsies were studied: 45 females (51.1) and 43 males (48.9). The most frequently affected age group was 31-40 years (26.1) followed by 41-50 years (21.6) Common presentations included hyperpigmented plaquespatches (33), erythematous lesions (23.9), hypopigmented lesions (12.5) and itchy plaques (13.6). Among major tissue reaction patterns our study found Lichenoid pattern (19.3) to be highest in number within which lichen planus (4) was most frequent. Followed by psoriasiform pattern (18.2) within which prurigo nodularis (6) was most frequent then granulomatous pattern (9.1). 11.4 cases were categorized under nonspecific lesions as few of them had non-specific findings and few others were inadequately sampled. Conclusion: Histopathological tissue reaction pattern analysis along with clinical features helps in  categorization which streamlines the diagnosis of non-neoplastic skin lesions in punch biopsies.