Mohammad Sajjad Khattak, Sajjad Ahmad, Mushtaq Ahmad.
Distribution of Histopathological Variants of Cutaneous Granulomatous Inflammation.
Gomal J Med Sci Jan ;15(2):74-7.

Background: A granuloma is defined as a circumscribed collection of modified macrophages with scattered giant cells and lymphocytes. It represents a cell mediated (type IV) hypersensitivity reaction. The objective of this study was to determine the pattern of different cutaneous granulomas. Material & Methods: This cross-sectional study was conducted in Pathology Department, Bannu Medical College, Bannu, KPK, Pakistan. The biopsies were collected from different hospitals of the area with relevant clinical information and supportive laboratory tests. Eighty six biopsies of cutaneous granulomatous inflammation from various anatomical locations were analyzed. Demographic variables were sex, age in years and age groups including 10-20, 21-30, 31-40, 41-50, 51-60 and 61-70 years. Research variables were; types of cutaneous granuloma with attributes of tuberculous granuloma, cutaneous leishmaniasis, fungal granuloma, foreign body granuloma, leprosy, sarcoid granuloma, malakoplakia and necrobiotic granuloma. Inclusion criteria was all biopsies of cutaneous granulomatous inflammation of any age, sex and location in body. Exclusion criteria was insufficient biopsy material, autolysed specimen and granulomas from sites other than of cutaneous location. Numeric variables were calculated with mean and SD whereas categorical as frequency and percentages. SPSS version 20 was used for analysis. Results: Out of a total of 86 cases of cutaneous granulomatous tissue biopsies, male to female ratio was 1.2:1. The age range was from 10- 70 years with mean age 34.47±13.55 years, The commonest age group was 21- 30 years with 39 cases (45.38%) followed by 31-40 years with 28 (32-55%) cases. The most common type of granuloma was tuberculous granulomas 63 (73.28%) followed by granuloma of cutaneous leishmaniasis 08 (9.30%), fungal granulomas 05 (5.81%), foreign body granulomas 04 (4.65%), leprosy 03 (3.84%) and one each (1.16%) of necrobiotic granuloma, sarcoid granuloma and malakoplakia. Conclusion: The tuberculous granulomas are the commonest granulomas in district Bannu, Pakistan, specially in 21-40 years of age.

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