Histopathological Evaluation of the Spectrum of Non-Neoplastic Skin Lesions at a Tertiary Referral Center

Background: Non-neoplastic skin lesions are a wide array of benign, inflammatory, cys tic, vascular, and reactive processes. Non-neoplastic skin lesions often mimic neoplastic diseases clinically. The clinical overlap with neoplastic entities makes histopathological examination the gold standard for a definitive diagnosis. Objective: The present retrospective study aims to delineate the histopathological chara teristic spectrum, the demographic characteristics, and the anatomical site distribution met rics of non-neoplastic skin lesions in biopsies received at Government Medical College, Anantnag, a tertiary care referral center. Methods: This present study was carried out over a one year period, wherein 109 consec utive non-neoplastic skin biopsy specimens sampled from Government Medical College, Anantnag, were reviewed. The demographic and clinical data were exerted from the re spective medical records. Histopathological evaluations were performed on formalin-fixed, paraffin-embedded hematoxylin and Eosin (H &E) stained slides. The descriptive statistics and data analysis were performed using Python 3.9 and associated directories. Significance tests like χ2 test and Fischer’s tests were used. Results: Patient ages ranged from 3 year old to 85 years with a mean age of 37.5 ± 18.0 years, and a male predominance (65 M : 44 F). Epidermal inclusion cysts (31%) were the most frequent lesions, followed by pilomatrixomas (11%) and keratinous cysts (8.0 %). Overall, the cystic lesions comprised 57% of the total cohort. We also documented a squamous cell carcinoma arising in an epidermal cyst (0.9%). Pediatric patients (<18years; n=7) showed a higher proportion of pilomatrixomas and keratinous cysts. The most common biopsy sites were the scalp (14%), chest (11%), and the neck (9%). Males were characterized by a significantly larger frequency of cystic lesions (75.4% vs. 51.3%, χ2 = 5.42, p = 0.02). Conclusion: Non-neoplastic cutaneous lesions were most common in middle-aged males, with cystic lesions predominating. Epidermal inclusion cysts were the most frequent, and pilomatrixomas were more common in children. Scalp was the leading biopsy site. One rare case of malignant transformation was noted