Histopathology and Ancillary Testing in the Accurate Diagnosis of Complex Skin Lesions

Almadaeeny, Shahad Esmat; Alharoon, Sawsan Saleh; Alhamdi, Khalil Ismail

doi:10.33762/mjbu.2026.156155.1276

	Histopathology and Ancillary Testing in the Accurate Diagnosis of Complex Skin Lesions
The Medical Journal of Basrah University
Article 10, Volume 44, Issue 1, July 2026, Pages 96-105 PDF (587.43 K)
Document Type: Research Paper
DOI: 10.33762/mjbu.2026.156155.1276
Authors
Shahad Esmat Almadaeeny^* ¹; Sawsan Saleh Alharoon²; Khalil Ismail Alhamdi³
¹Basra health directorate
²College of medicine, University of Basrah
³University of Basrah,College of medicine
Abstract
Background: Skin conditions are among the most common health problems and not always easy to diagnose. Challenging and create complex cases, the correlation between histopathology and clinical features is essential to solve this problem. Aim of the study: This study aims to evaluate the correlation between clinical and histopathological diagnosis in complex skin lesions, and the role of ancillary tests in enhancing diagnostic accuracy. Material and Methods: A cross-sectional prospective study was conducted in the Department of Histopathology and Dermatology at Al-Sadr Teaching Hospital and Basrah Teaching Hospital, Basrah, Iraq, from October 2023 to October 2024. Two hundred nineteen cases inclusion criteria include a complex skin lesion were collected, History and clinical findings were obtained from each patient, and histological sections were stained using immunohistochemistry (IHC) and special stains, as required for each case. Results: Among 219 cases, only 77 cases (35%) were considered complex in which histopathological diagnosis did not correlate with the given clinical diagnosis, which included 58 cases (26.5%) with disagreement between histological and clinical diagnosis and 13 cases (5%) with a clinicopathological agreement, after using special stains, in addition to 6 cases (2.7%) which remained undiagnosed (inconclusive). Conclusion: The integration of clinicopathological correlation is crucial for achieving accurate and quick diagnosis. IHC and special stains are essential in diagnosing some complex cases. Most cases were found in females. Non-neoplastic skin lesions were the major entity. Mycosis fungoides was the most common neoplastic complex lesions.
Keywords
Skin lesions; complex cases; clinico-pathological correlation; ancillary tests; histopathological diagnosis

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