Clinico Pathological Study of Skin Surface Epidermal and Appendageal Tumours.

Tumours of epidermis are histopathologically diverse group of entities which have in common a localized proliferation of keratinocytes resulting in clinically discrete lesions. They may be divided into a number of categories, reflecting their different biological behaviour.These includes hamartomas, benign tumours, premalignant and malignant conditions. The cutaneous appendages give rise to a bewildering number of neoplasms (more than eighty in number).Various classification have been proposed in the past which have required modifications from time to time in the light of most recent ultra structural, histochemical findings and the reporting of new morphological entities. This study of tumours of epidermis and appendages has been undertaken to find out the frequency of benign and malignant growths. The study has been limited to the cases attending the Dermatology Department, Government General Hospital, Chennai. Most of the tumours whether benign or malignant are symptom less but are cosmetically unacceptable. This study is based on the classification of tumours given in the LEVERS histopathology of skin 8th edition and is confined to the tumours of epidermis and appendages. AIMS AND OBJECTIVES: To find out the 1. Overall frequency of surface epidermal and appendageal tumours reported in the out-patient department of dermatology, Government hospital, Chennai. 2. Different clinical presentation such as morphology, site and their associations with other skin and systemic conditions. 3. Histopathological features of various tumours encountered. CONCLUSIONS : Majority of the patients reported with the skin tumours of epidermis and appendages were adults (83.44 %). The tumours such as epidermal nevus, nevus sebaceous occur in childhood (16.66 %) and these need awareness among the parents to bring the children at an early age. Most of the skin tumours in this study occurred in the age group of 21-30 years and 51-60 years (23.33 % ). The reporting of the skin tumours was more by the females (53.33 %) compared to males (46.66 %) probably because of their cosmetic awareness. The commonest tumour encountered in this study was syringoma (20 %) which were mainly in the infraorbital region and with classical histopathology. The second common tumour was seborrheoic keratosis (16.66 %). All the patients had there lesions in the sun exposed areas except one female who had multiple lesions and having classical histopathology. Epidermal nevus and epidermal cysts (15%) were the third most common tumour in this study. One case of epidermal nevus was associated with seizures and visual disturbances. Basal cell carcinoma (8.33%), squamous cell carcinoma (5%), trichoepithelioma (5%), keratoacanthoma (5%),steatocystoma multiplex(3.33% ), nevus sebaceous (5 % ), sebaceous carcinoma (1.66% ) were also encountered in our study with classical clinical and histo- pathological findings. Rare case like with xeroderma pigmentosum with squamous cell carcinoma was encountered in a male patient. One case of squamous cell carcinoma associated with growth retardation and hypogonadism was recorded in this study. One case of sebaceous carcinoma of the right cheek was encountered in an albinoid female with characteristic histopathology