Clinicopathological features of granulomatous skin lesions

Granulomatous skin lesions are characterized by aggregation of activated histiocytes. Granulomatous skin lesions are classified as xanthomatous, necrobiotic, tuberculoid, sarcoidal, and foreign body types. This study evaluates the clinicopathological features of patients with granulomatous skin lesions. We conducted a cross-sectional study of 232 skin biopsies diagnosed as granulomatous skin lesions over ten years from patients referred to Afzalipour Hospital, Kerman, Iran. Demographics, clinical features of lesions, and pathological characteristics were recorded. Then, the correlation of the final diagnosis with the demographic and clinical features of the patients was assessed via the independent t-test and chi-squared test. Most patients were in their third decade of life, with a male-to-female ratio of 1.05 to 1. The most common types of granuloma were tuberculoid (60.3%), necrobiotic (12.5 %), and foreign body type (11.2%). Infectious disease was the most common cause of granulomatous lesions (64.2 %); leishmaniasis constituted approximately 96% of cases. The most common causes of noninfectious granulomatous skin diseases were foreign body granuloma (26.2%), granuloma annulare (23.2%), and xanthogranuloma (12.1%). There was a significant correlation between dermatologic disease type and disease duration (P = 0.024). In the current study, the most common type of granuloma was tuberculoid, followed by necrobiotic and foreign body type granulomas. Infectious diseases were the most common cause of granulomatous skin lesions. Furthermore, the most common granulomatous skin diseases were leishmaniasis, foreign body granuloma, and granuloma annulare. The least common granulomatous skin lesions were sporotrichosis and gout.