ORIGINAL: Concordance Between Clinical and Histopathological Diagnosis of Skin Diseases in South-South Nigeria: A Two-Center Study

West Afr J Med. June 2024; 41(6): 617-624 PMID: 39340193

Abstract

Background: An accurate diagnosis is the bedrock of the treatment of skin diseases. This study aimed to evaluate the correlation between clinical and pathological diagnosis of patients with skin disorders seen in dermatology units of Federal Medical Centre (FMC), Asaba, Delta State, and the University of Benin Teaching Hospital (UBTH), South-South Nigeria between 2019 - 2021.

Material and methods: This was a retrospective study of the charts of all patients seen in the dermatology units of FMC Asaba and UBTH who had skin biopsies for various skin diseases from 2019 to 2021. Biodata, clinical information, diagnosis, and histology results of these patients were collected using a questionnaire. One hundred and sixty-two (162) patients were excluded on account of the absence of a clinical diagnosis and a pathological conclusion of insufficient tissue sample.

Results: 356 skin biopsies were included. The male-to-female ratio was 1:1.18 and most patients were aged 40 to 49 years 74 (20.8%) with a mean age of 38.28± 19.19. Papulosquamous skin disorders accounted for 141 of the clinical diagnoses (39.0%) Among the histology request forms filled, only 69 (19.4% ) had detailed clinical history. Clinico-pathological concordance (CPC) was recorded in 214 (60.1%) cases and discordance in 142 (39.9%), both the highest concordance and discordance percentages were among papulosquamous diseases (45.1% and 31.5% respectively). There was no significant association between the completeness of documentation of patient's clinical information and clinicopathological concordance.

Conclusion: Although the CPC was above 50% in this study, better modalities of communication between dermatologists and pathologists is desired.