A 5-year retrospective review of skin adnexal tumours received at a tertiary dermatopathology service: implications for linked genetic diagnoses

Abstract

Background Skin adnexal tumours (SATs) comprise a diverse range of neoplasms, which are difficult to diagnose clinically. They present in paediatric and adult populations, and may be indicative of an underlying genetic syndrome. There is a lack of recent data on the presentation of these tumours in clinical practice in European populations. Objectives To characterize the clinical and pathological features of SATs received at a single tertiary centre over a 5-year period. Methods A retrospective health record audit of SATs received at the Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, during the period November 2012 to October 2017 was performed. Results In total, 107 144 skin cases were received during the audit period. A total of 1615 cases of SATs from 1359 patients were included; 1570 (97Á2%) were benign and 45 (2Á8%) were malignant. Overall, the average age at presentation was 55 years (range 11 months to 97 years) and the male to female ratio was 0Á77 : 1. Sweat gland and hair follicle SATs were most frequently excised; in adults, the most frequent tumour was hidrocystoma, and in children, pilomatrixoma occurred most often. Prebiopsy diagnosis was correct in 28% of cases. Benign SATs are often markers of an associated genetic condition, which warrants improved discrimination of sporadic from genetically related SATs. Conclusions SATs are difficult to diagnose clinically, and clinicopathological correlation may help enhance discrimination of genetically related SATs from sporadic cases. These data have implications for clinical and dermatopathological training provision, the development of reporting standards, and genetic assessment of selected patients.What is already known about this topic?• Skin adnexal tumours (SATs) comprise a diverse range of neoplasms, which arise from the hair follicle, sebaceous and eccrine glands.• Clinical diagnosis is difficult owing to the lack of discriminatory features.• Selected SATs are recognized markers of underlying genetic conditions, but the proportion of these tumours occurring in unselected European populations is not known.

Five‐year pattern of adnexal tumors of the skin in Ethiopia

“…16 The most frequent line of differentiation in our study was sweat gland (48.6%), followed by follicular (33.6%) and sebaceous (16.4%). This finding is similar to many of the previous studies done in the United Kingdom, 11 Turkey, 25 India, 7,11,[28][29][30] Nigeria, 9,20,23 and Egypt. 16 However, a study in India by Kala et al and Sinha et al, 18,27 a study in Nepal, 19 a study in Burkina Faso, 31 Morocco, 21 and a study in Slovakia 1 found hair follicle tumors to be the most common.…”

“…The study found the magnitude of skin adnexal tumors to be 2.8% of the total biopsies obtained during the 5-year period. This finding was higher than a previous study done in the United Kingdom, which reported 1.5% (of a total of 107,144 biopsy samples received), 11 and multiple Indian studies by Sonam et al 12 which found 0.12% magnitude of the total surgical pathology specimens, Thakuria et al 13 which found 0.62% (of a total of 4013 biopsies received), by Deka and Osman found the incidence of SATs to be 0.015% of all skin biopsies which were 1,221, 16 whereas lower than a study in Iran which reported 3.3% (of 30,000 pathology records). 17 The higher finding in our study might be because it studied the magnitude of all types of adnexal proliferations, not only neoplasms but also hamartomas, hyperplasias, and cysts arising from adnexal structures.…”

“…Most other studies also reported female predominance. 11,12,16,19,[22][23][24][25] A larger number of men was reported by a study in Slovakia which found M : F = 1.2 : 1, 1 an Egyptian study which reported M : F = 1.5 : 1, 16 a Moroccan study which found M : F = These differences must be related to the different proportions of the specific tumor types which have gender disparities. For example, syringoma is reported more commonly in females.…”

Clinicopathological Spectrum of Benign Skin Adnexal Tumors in the Pakistani Population: A Single-Center Study

“…The mean age range was 40.97±19.3 years in our study, which is similar to the study conducted by Yaqoob N et al [ 9 ], while the mean age was 28.2±9.45 years in a study published by Preeti et al, which is discordant with our findings [ 10 ]. Female gender predilection was noted in our study which is similar to the study conducted by Sam et al [ 11 ]. This is in contrast to the study done by Bansal A et al who cited male predominance [ 12 ].…”

Skin adnexal tumours in a tertiary dermatopathology service

“…In their valuable cross‐sectional 5‐year retrospective study published in this issue of the BJD , Cook et al . provide an excellent insight into adnexal tumours in a tertiary‐centre practice 1 …”