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Background: Only a few clinicopathological epidemiological studies detailing histopathologically diagnosed skin diseases have been carried out in Nigeria. Thus, the aim of this study was to retrospectively survey the histopathological spectrum and clinicopathological concordance of histopathologically diagnosed skin diseases in Nigeria over a 16-year period. Materials and Methods: This study involved the assessment of all skin biopsy specimens received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from January 2004 to December 2019. Histopathological diagnoses based on these skin biopsies were made by consultant anatomical pathologists using routine hematoxylin and eosin-stained slides. All relevant demographic data and provisional clinical diagnoses were obtained from the histopathology laboratory requisition forms provided with the specimens. The skin lesions were then classified according to the International Classification of Diseases, Tenth revision (2019). Results: A total of 347 skin lesion biopsy specimens were included in this study. Most of the patients were aged 20–39 years old, with a mean age of 34.2 years. One hundred and forty-eight (42.7%) of the patients were males, whereas 199 (57.3%) were females. The most common 1CD-10 categories were disorders of skin appendages (105/347 [30.3%] cases) and papulo squamous disorders (81/347 [23.3%] cases), whereas the least common category was radiation-related disorders of the skin (2/347 [0.6%] cases). The most common disorder of the skin appendage was epidermal inclusion cyst (71/105 [71.4%] cases). Lichen planus was the most common papulosquamous disorder observed (26/81 [32.1%] cases). Only 202 cases included records of the biopsy site. The lower extremities were the most common sites of involvement (48/202 [23.8%] cases). The clinical diagnosis was concordant with the histopathological diagnosis in 55.3% of the cases, whereas it was discordant in the remaining cases. Conclusion: The most common skin diseases observed in this study were disorders of skin appendages and papulosquamous lesions. Our study provides baseline data for future population-targeted studies of nonneoplastic skin diseases.

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