10 year retrospective analysis of histopathological examination results and direct immunofluorescence findings on skin punch biopsy materials in our archives

Skin diseases are among the top five most common diseases according to the classification made by the World Health Organization. Skin biopsy is one of the most commonly used diagnostic methods in dermatology. In addition, the pre-diagnoses and clinical information to be given by the clinician for the correct diagnosis in pathological examination are important in terms of clinicopathological correlation. The heterogeneity in the clinical presentation of skin diseases makes histopathological examination a gold standard technique for definitive diagnosis and clinicopathological correlation. Direct immunofluorescence (DIF) examination is a valuable examination used in addition to clinical and histopathological findings in the diagnosis of various dermatological disorders. The location and pattern of accumulation of immunoreactants helps to classify various immune-mediated diseases. DIF examination may constitute the third pillar that will contribute to clinical and histopathological evaluations. In our study, we aimed to evaluate the demographic characteristics, lesion localizations, lesion types and clinicopathological compatibility, and the compatibility between histopathological examination results and DIF findings. The reports of the skin punch biopsy materials of 2753 cases sent to the Medical Pathology Laboratory of Afyonkarahisar University of Health Sciences Faculty of Medicine, Department of Dermatology and Venereal Diseases between 01.01.2010-30.12.2019 were retrospectively analyzed. Among these cases, DIF findings of 213 cases, which also included DIP examination, were also retrospectively described. Clinicopathological compliance with the obtained data and the consistency between histopathological examination results and DIF findings were evaluated. The data obtained were evaluated with descriptive statistics. A statistical comparison was made between the clinicopathological compliance and the groups with and without DIF compliance in terms of age, gender, biopsy location and disease groups. SPSS v20 program was used for the statistical evaluation and analysis of the obtained results. Clinicopathological correlation was found at a rate of %70,9. It was observed that gender, age and biopsy site had no effect on clinicopathological correlation. It was observed that the clinicopathological agreement was significantly higher in psoriasiform and pustular dermatitis and lichenoid and interphase dermatitis. It was found that gender did not have an effect on the correlation of first prediagnosis, but in the biopsies taken from the lower extremities and in the elderly people aged 50 years and over, the consistency of the first prediagnosis was significantly higher. In addition, it was observed that the first pre-diagnosis compliance of the disease groups, psoriasiform and pustular dermatitis, vascular tumors and vascular diseases, was significantly higher. The proportion of patients with DIF pattern consistent with the histopathological diagnosis was %79,8 and DIF sensitivity was %95. While it was observed that gender and age did not have an effect on DIF compliance in DIF cases, it was observed that DIF compliance was significantly lower in biopsies taken from the head and neck region. However, it was observed that DIF compliance of vesiculobullous diseases and vasculitis among the disease groups was close to the general DIF compliance. Our findings will expand the data in the literature and shed light on the issue that dermatologists can identify the patients who will benefit most from the biopsy request. Further large-scale studies are needed to elucidate the factors that may affect clinicopathological compliance and histopathological diagnosis and DIF compliance.