The accuracy of clinical diagnosis in 2135 lesions on the face: A retrospective analysis of histopathological records

Anna Czaplicka; Magdalena Misiak-Gałązka; Joanna Czuwara; Adam Gałązka; Barbara Górnicka; Lidia  Rudnicka

doi:10.5826/dpc.1204a159

The accuracy of clinical diagnosis in 2135 lesions on the face

A retrospective analysis of histopathological records

Authors

Anna Czaplicka Department of Dermatology, Medical University of Warsaw, Poland
Magdalena Misiak-Gałązka Department of Dermatology, Medical University of Warsaw, Poland
Joanna Czuwara Department of Dermatology, Medical University of Warsaw, Poland
Adam Gałązka Department of Head and Neck Cancers, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
Barbara Górnicka Department of Pathology, Medical University of Warsaw, Poland
Lidia Rudnicka Department of Dermatology, Medical University of Warsaw, Poland

Keywords:

dermatopathology, cancer, standardized skin surface biopsy, face, inflammatory diseases

Abstract

Introduction: Biopsy of facial skin lesions is an important supplement to dermatological diagnostics, especially in doubtful cases or suspected of being malignant.

Objectives: The aim of the retrospective study of 2135 histopathological records of lesions on the face was to:

1). establish the most common indications for a skin biopsy in patients with facial lesions,

2). establish the frequency of histopathological diagnoses,

3). evaluate how often clinically suspected inflammatory lesions are identified as tumors in histopathology,

4). evaluate the accuracy of clinical diagnoses of the most common skin tumors and dermatoses.

Methods: It was a retrospective study. Histopathological records from the lesions on the face from years 2010-2017 were analyzed.

Results: The mean age of patients was 69.3 [7-98]. 58.28% of the patients were women. Among 2135 clinical diagnoses skin tumors were suspected in 1905 cases. Among 2169 obtained histopathological results (34 biopsies showed two diseases), we identified skin tumors in 1940 cases, with 1388 confirmed as malignant. The clinical diagnosis of a specific benign or malignant skin tumor was accurate in 1013/1634 subjects, in comparison to inflammatory lesions, which were correct in 67/148 cases, (p=0.0001). Among all preliminary inflammatory diagnoses, 33/204 lesions were identified as skin tumors in histopathology.

Conclusions:In conclusion in most cases of skin tumors the clinical diagnosis is confirmed by histopathological examination. In case of facial inflammatory lesions, the accuracy of clinical diagnosis is lower, with a significant number of facial lesions appearing inflammatory in clinical evaluation but being diagnosed as skin cancers in pathology.

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