Value Of Skin Biopsy As A Diagnostic Procedure In Dermatology

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The role of dermatopathology has expanded in the past decades from routine histology to involve immune pathology, ultra structural, and molecular biological techniques. The aim of this study was to test the value of skin biopsy as a diagnostic procedure in the diagnosis of variable skin disorders in Benghazi, Libya.

Over a period of 4 years; 200 patients were seen by a consultant dermatologist in Jumhori hospital skin department-Benghazi, Libya, for them a skin biopsy was performed to establish the diagnosis. Specimens were subjected to routine histopathological examinations (Haematoxylin and Eosin) by a general pathologist then reviewed clinically and pathologically by the dermatologist. There was a direct communication between the dermatologist and pathologist to obtain final diagnosis after clinicopathological correlation and to plan for further workup if needed.

Pathological diagnosis was consistent with one of the clinical differential diagnoses in 82%, gave a new diagnosis in 6% and was non-diagnostic in 12 %. After clinicopathological reviewing of the cases; concordance between pathological and final diagnosis occurred in 58% whereas clinicopathological correlation gave the diagnosis in 18%. In 24% further investigations were required; special stains were needed in 7 %, immunofluorescent studies in 9%, electron microscopy in 2%, immunohistochemistry in 6% and molecular biological technique was required in 3%. Special stain was done for 2%, immunohistochemistry for 1%, whereas in the remaining 21% we could not sit a final diagnosis due to the unavailability of the required techniques.

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