Clinicopathological concordance in the diagnosis of skin diseases: a retrospective analysis of 5000 histopathology reports
Al-Saif, Fahad Mohammed . 2019
388
Clinicopathological concordance in the diagnosis of skin diseases: a retrospective analysis of 5000 histopathology reports
Fahad Mohammed Al-Saif,ab Salman Abdulaziz Binsufayan,ab Abdulaziz Hasan Alhussain,a Tuqa Morad Alkaff,a Hesham Mohammed Alshaikh,ab Mosfer Saeed Aldosari,ab Saud Abdulaziz Binsufayan,a Rawan Murshed AlTaleb,a Hend Metia Alotaibi,ab Mohammed Abdulaziz Alshahwanab
From the aDepartment of Dermatology, College off Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia; bDepartment of Dermatology, King Saud University, Riyadh, Saudi Arabia
BACKGROUND: The accuracy of clinical diagnoses of skin diseases has not been researched in Saudi Arabia.
OBJECTIVES: Assess concordance between the histopathological and clinical diagnosis in skin diseases.
DESIGN: Retrospective.
SETTING: Academic tertiary care center.
METHODS: Demographic, clinical and pathological data were collected from the medical record for the period 1997-2013.
MAIN OUTCOME MEASURES: Concordance between the pathological and clinical diagnosis.
SAMPLE SIZE: 4268 cases.
RESULTS: Of 4268 biopsies, 2440 (58.1%) were females. The mean age (SD) of patients was 36.9 (17.8) years. The three most common locations from which skin biopsies were retrieved in descending order were the lower extremity (1123; 29.1%), head, neck, scalp and hair (1033; 26.7%) and trunk (853; 22.1%). Overall concordance was 75.9% (partial concordance 47.6%, full concordance 28.3%). Biopsies from the oral mucosa and lips had the lowest concordance (overall 58.5%, full 26.4%) at P=.004. Overall concordance was highest for the following three diagnoses: malignant neoplasms, 88%; vesiculobullous diseases 87%; urticarias, erythemas, and purpuras 87%.
CONCLUSION: There is considerable variability in concordance among different histopathological diagnoses. The full concordance between the clinical diagnosis and the pathological diagnosis is low. This is a reflection of the fact that the biopsies were obtained only in cases where the clinical diagnosis was a dilemma.
LIMITATIONS: Single center, retrospective, incomplete medical records, low percentage of biopsies were assessed by dermatopathologists.
CONFLICT OF INTEREST: None.
Correspondence: Dr. Salman Abdulaziz Binsufayan · Department of Dermatology, King Khalid University Hospital, Riyadh 11462, Saudi Arabia · T: +966555999864 · sabinsufayan@gmail.com · ORCID: https://orcid.org/0000-0002-3065- 6794
Citation: Al-Saif FM, Binsufayan SA, Alhussain AH, Alkaff TM, Alshaikh HM, Aldosari MS, et al. Clinicopathological concordance in the diagnosis of skin diseases: a retrospective analysis of 5000 histopathology reports. Ann Saudi Med 2019; 39(6): 388-394. DOI: 10.5144/0256-4947.2019.388
Received: April 05, 2019
Accepted: August 27, 2019
Published: December 5, 2019
Copyright: Copyright © 2019, Annals of Saudi Medicine, Saudi Arabia. This is an open access article under the Creative Commons Attribution-NonCommercial- NoDerivatives 4.0 International License (CC BY-NC-ND). The details of which can be accessed at http:// creativecommons. org/licenses/by-nc-nd/4.0/
Funding: None.
Georg Thieme Verlag KG Stuttgart · New York
LEOPARD Syndrome with PTPN11 Gene Mutation in Three Family Members Presenting with Different Phenotypes
Nuha Alfurayh
1 …
388
Clinicopathological concordance in the diagnosis of skin diseases: a retrospective analysis of 5000 histopathology reports
Multiple bilateral Becker’s nevus in a Saudi female: a rare presentation
Alanoud Alhuqayl, Fahad Alsaif, Alaa Alsaad, Azhar Alali