Clinicopathological correlation of hyperpigmented skin lesions with special emphasis on alkaline Congo red stain for amyloid detection

Introduction:Hyperpigmented skin disorders comprise a group of diseases of extreme heterogeneity of epidermal and dermal origin. Histopathology along with clinical features are sufficient for confirmation of clinical diagnosis in majority cases. Confirmation of amyloidosis is required by special stain for amyloid.Aims : In view of this scientific knowledge, the present study is undertaken to find out occurrence, morphological variants and clinico-pathological correlation of different pigmented skin lesions with an emphasis on the detection of the amyloid material by alkaline congo red stain under light microscopy.Study design : Observational study with cross sectional design. The study was performed in Department of Pathology of a state run medical college of northern part of West Bengal.52 patients were taken in the study maintaining the inclusion and exclusion criteria. Results : 52 patients with different hyperpigmented lesions were studied. The most common lesions were Lichen planus pigmentosus (28.8%). Most common lesions were found in this study are in the age group of 3rd and 4th decade. The patients arrived with hyper pigmented lesions had female predominance except Lichen amyloidosis. 3.8% cases were Lichen amyloidosis & 9.6% cases were macular amyloidosis & showed eosinophilic amorphous substance in hematoxylin and eosin stain in 100% cases. Apple green birefringes under polarized microscopy seen in 100% cases in this study.Conclusion: Out of 52 cases, 84% cases correlated clinically and histopathologically. So a good histopathological diagnosis is necessary for the accurate diagnosis and definite treatment of patients with pigmented skin lesions