ABSTRACT

Nodular skin lesions are a common diagnostic dilemma because of overlapping clinical features. Histopathology remains the gold standard for diagnostic confirmation.

The aim of this article is to analyze the clinico-epidemiology and histological spectrum of nodular skin lesions along with clinico-pathological correlation.

A cross-sectional study was conducted including 114 new patients with cutaneous nodules. Each patient was subjected to detailed clinical examination and histopathological examination to obtain the final diagnosis and degree of histomorphological concordance.

Neoplastic disorders accounted for 42.9% of the skin nodules among 114 patients (mean age 33.2 ± 11.9 years; M: F 1.7:1), followed by miscellaneous (30.7%), infective (19.3%), and deposition (7%) disorders. The most common cause was lipoma (19.3%), followed by prurigo nodularis (12.3%), leprosy (11.4%), and neurofibroma (9.6%). Most common site was trunk, and pruritus is the commonest symptom. Multiple clinical differentials were considered for almost one-third of patients owing to overlapping clinical features, and histology provided the final diagnosis. On clinico-pathological correlation, 72.8% of the cases showed histopathological concordance, whereas the remaining cases were histologically discordant (7%) or inconclusive (20.2%).

Neoplastic disorders (benign> malignant) are the most common cause of nodular skin lesions. In addition to detailed clinical examination, histopathology is necessary to confirm the diagnosis and rule out differentials. Considerable histopathological correlation can be obtained for skin nodules if performed appropriately.