Histopathology audit of pigmented skin lesions at a tertiary care hospital in rural Bangalore, South India

Abstract

Background: Pigmented skin lesions are a frequently encountered skin lesion in routine dermatological practice. About 90% of them are benign, and a small percentage are malignant. Clinically, many of these lesions can mimic melanocytic tumours, including malignant melanoma, creating diagnostic challenges. The present study was undertaken to evaluate the histopathological spectrum of pigmented skin lesions and their clinicopathological correlation in rural population of South India.

Materials and Methods: This hospital-based, cross-sectional study was conducted in the Department of Pathology at a tertiary care hospital in rural Bangalore over a period of 4 years, January 2021 to January 2025, after prior ethical approval. A total of 119 cases of pigmented skin lesions were included using convenience sampling. Descriptive analysis was done.

Results: Out of the 119 pigmented skin lesions, 66(55.46%) cases were melanocytic, and 53(44.5%) were non-melanocytic. Malignant melanoma accounted for 7(5.8%) cases among melanocytic lesions, while pigmented basal cell carcinoma constituted 10(8.4%) cases among non-melanocytic lesions. A female preponderance was observed, with the most affected age group being 21–40 years. The head and neck region was the most frequently involved site, 73(61.34%) cases. Clinicopathological correlation was observed in 87(73.1%) cases, while 32(26.89%) cases showed discordance.

Conclusion: Benign melanocytic nevi constituted the majority of lesions, while malignant melanoma and pigmented basal cell carcinoma represented the most common malignant counterparts. The observed clinicopathological discordance highlights the limitations of clinical assessment alone and highlights the role of histopathological examination in establishing accurate diagnosis.