IP Archives of Cytology and Histopathology Research 2019;4(3):209–215 Content available at: iponlinejournal.com IP Archives of Cytology and Histopathology Research Journal homepage: www.innovativepublication.com Original Research Article Cutaneous mycobacterial lesions- A retrospective study in a tertiary care hospital Keval A. Patel 1 , Riti P. Dixit 1, *, Riddhi A. Parmar 1 , Arohi P. Parekh 1 , Bhawana S. Sharma 1 1 Dept. of Pathology, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India ARTICLE INFO Article history: Received 26-07-2019 Accepted 05-08-2019 Available online 01-10-2019 Keywords: Necrotizing Granuloma Mycobacterium tuberculosis Mycobacterium leprae ABSTRACT Introduction: Mycobacterial dermal lesions pose diagnostic challenge and require histopathological examination for confirmation. Granuloma is an important histopathological feature present in most of the mycobacterial dermal lesions. Multiple etiologies can produce an identical histopathological picture. The present study was undertaken with the objective to study the spectrum of mycobacterial dermal lesions, their etiologies and their incidence in this geographical area. Materials and Methods: This present study was carried out in Department of Pathology G.K General Hospital, Bhuj for a period of one year. A total of 50 cases mycobacterial dermal lesions of all etiologies are included in the present study. Hematoxylin and eosin stain was routinely done on all cases. Special stains like Ziehl-Neelsen, Fite Faraco, Periodic acid–Schiff stain were done whenever required. Conclusion: Histopathology is gold standard to diagnose mycobacterial dermal lesions. Along with it, the clinical presentation of the patient is also very important in elucidating the exact etiology. © 2019 Published by Innovative Publication. 1. Introduction Mycobacterial infections occur most commonly in immuno- compromised patients and also resurge in them. Necrotizing granulomatous inflammation is the commonest histopatho- logical manifestation in mycobacterial skin infections. 1 Granulomatous inflammation of skin is a known histo- logical pattern encountered commonly in skin biopsies. It possesses a diagnostic challenge to the pathologist because its etiopathogenesis is variable as well as the dermatologists. These granulomatous lesions share the histopathological denominators of the granuloma formation. 2 Infectious and non-infectious causes can lead to granulomatous lesions of skin. Mycobacterial infection, non mycobacterial infection, mycobacterial leprae infection, leishmaniasis and fungal infections are common etiologies. 3 Cutaneous mycobacterial infections may causes a wide range of clinical manifestation viz, 1) Cutaneous manifestation of Mycobacterium Tuberculosis (MTB), 2) Buruli ulcer and M. ulcerans, 3) Leprosy caused by M.leprae, 4) Cutaneous * Corresponding author. E-mail address: rsinha75@gmail.com (R. P. Dixit). infection caused by rapidly growing mycobacteria. Though special stains are helpful in making a definite diagnosis, at times only the histopathological pattern and its correlation with the clinical picture that aids in making a definitive diagnosis. The term “granuloma” was coined by Virchow, to describe a tumor like mass or nodule of granulation tissue. 4 The granulomatous reaction pattern is defined as a distinctive inflammatory pattern characterized by the presence of granulomas. Granulomas are relatively discrete collections of histiocytes or epithelioid histiocytes with variable numbers of admixed multinucleate giant cells of varying types and other inflammatory cells. 3 Several etiologies can produce an identical histopatho- logical pattern and conversely a single etiology can produce multiple histopathological pattern. The present study was conducted with the aim to study the histopathological spectrum of pattern of mycobacterial dermal lesions and identification of their etiology. https://doi.org/10.18231/j.achr.2019.040 2581-5725/© 2019 Published by Innovative Publication. 209