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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,
BANGALORE.
ANNEXURE – II.
PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1. NAME OF THE CANDIDATE AND : Dr. SHASHIKUMAR. S .D
ADDRESS
POST GRADUATE IN PATHOLOGY,
DEPARTMENT OF PATHOLOGY,
MYSORE MEDICAL COLLEGE AND
RESEARCH INSTITUTE,
MYSORE - 570 001.
2. NAME OF THE INSTITUTION
: MYSORE MEDICAL COLLEGE AND
RESEARCH INSTITUTE, MYSORE.
3. COURSE OF STUDY AND
SUBJECT
: M. D. PATHOLOGY.
4. DATE OF ADMISSION TO
THE COURSE
:
5. TITLE OF THE TOPIC
: “HISTOPATHOLOGICAL STUDY OF
NEOPLASTIC LESIONS OF SKIN AND
ADNEXAE”
14-08-2012
6. BRIEF RESUME OF THE INTENDED WORK:
6.1 NEED FOR THE STUDY:
Histopathological study of neoplastic lesions of skin and adnexae plays an
important part in dermatopathology .The need for the histopathological study is
very essential in differentiating the tumors into benign, premalignant and
malignant categories .Tumor and tumor like lesions arise from different
components of skin such as surface epithelium, epidermal appendages and
dermis. They pose a diagnostic challenge because of their morphologic overlap
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and biological heterogeneity. The study is undertaken to study the various
histopathological features in skin and adnexal tumors with respect to age, sex
and site. Benign and malignant tumors if diagnosed early and treated have a
higher rate of cure. The present study is primarily aimed at achieving early
diagnosis with special emphasis on diagnosis of premalignant conditions.
Skin cancers are relatively uncommon malignancies worldwide. There has been a
progressive increase in the incidence of skin cancers since a decade. Three most
frequent primary skin cancers are basal cell carcinoma, squamous cell carcinoma
and malignant melanoma.
In India, skin cancers constitute about 1 -2% of all
diagnosed cancers. Sqamous cell carcinoma is the commonest form of skin
cancer. The overall incidence of skin cancer varies from 0.5 to 2 per 1 lakh
population.
6.2
REVIEW OF LITERATURE:
A population based skin cancer screening intervention was conducted in the
German state of Schelswig-Holstein. In this study, 15983 skin excisions were
performed. A total of 3103 malignant skin tumors were diagnosed in 2911
persons: 585 cases of malignant melanomas, 1961 cases of Basal cell carcinoma,
392 cases of Sqamous cell carcinoma and 165 other malignant tu mors were
diagnosed. 1
A retrospective study was conducted at the Department of Pathology S.S.I
Medical Sciences, Davangere for clinicopathological evaluation of Non Melanoma Skin Cancer [NMSCs], 60 were histologically categorized as skin
malignancy, of which 31 were NMSC. Squamous cell carcinoma was the most
common NMSC, constituting 26 cases and Basal cell carcinoma
which
constituted 5cases. NMSCs are often associated with greater morbidity, thus
necessitating increased efforts to assess risk factors in individuals. 2
A retrospective study of clinicopathological features of eyelid skin tumor s was
conducted at Ophtalmique Jules Gonin, Lausanne, Switzerland. In this study ,
2
5504 eyelid skin tumors were studied in which benign tumors predominated over
malignant ones. The 5 most frequent subtypes were Squamous cell papilloma,
seborrheic keratosis, melanocytic nevus, hidrocystoma and xanthoma. Basal cell
carcinoma was the most frequent malignant tumor, followed by squamous cell
carcinoma and sebaceous carcinoma. 3
In a retrospective study of Appendageal Skin Tumors conducted at
College Hospital,
Trivandrum ,
which 10(30.30%) were males and
Medical
thirty three patients were analyzed, out of
23(69.70%) were females. Of these, Eccrine
tumors were the commonest. Face was the commonest site to be affected (25
cases) followed by the scalp (24 cases). Appendageal skin tumors are relatively
uncommon. Histopathology was found to be mandatory for diagnosis. 4
A retrospective study was conducted at Laboratoire d’ Histopathologie Cutanee,
Strasbourg, France where 13457 cases of Basal cell carcinoma (BCC) were
studied. Of these BCCs, 78.7% were nodular, 15.1% superficial and 6.2%
morphoeiform .Nodular and morphoeiform types predominated in the head. The
Superficial type was found on the trunk. 5
A study was conducted on histopathological sections from 24 patients with
malignant melanoma of the eyelid skin. It was concluded that, nodular melanoma
patients with lesion in the lid margins had a worse prognosis than those with the
lesions on the eyelid skin. More than half of the tumors were located on the
eyelid margin. 6
In another study which was conducted by Department of Laboratory Med icine
and
Pathology, Minnesota, 14 cases of Eccrine carcinoma were studied which
included 5 males and 9 females. Ductal Eccrine carcinoma was found in 10
cases, eccrine porocarcinoma in 1 and mucinous carcinoma in 3 cases. Four
patients with ductal eccrine carcinoma suffered metastasis and a 50% mortality
rate was observed among this group of 10 cases. 7
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6.3 OBJECTIVES OF THE STUDY:


To study histomorphology of neoplastic lesions of skin and adnexae.
To describe the spectrum of various neoplastic lesions of skin and adnexae.
7. MATERIALS AND METHODS:
7.1 SOURCE OF DATA:
Specimens received from K.R.Hospital, Mysore Medical College and Research Institute,
Mysore, over a period of 18 months.
Sample size: 60 subjects with neoplastic skin and adnexal lesions.
Duration of the study: 18 months (1st December 2012 to 31st May 2014).
7.2 METHODS OF COLLECTION OF DATA
Specimens received at pathology department shall be taken up, fixed in 10%
formalin and processed. Multiple sections each measuring 4 micron in thickness
shall be obtained and stained with haematoxylin and eosin and microscopic
features of the lesions shall be studied.
Special stains shall be performed wherever necessary and relevant
clinical details and laboratory data shall be obtained from subjects records. The
final diagnosis in each case will be established by correlative study of clinical
and histopathological findings.
.
7.3 INCLUSION CRITERIA:
Benign and malignant lesions of the skin and adnexae.
7.4 EXCLUSION CRITERIA
None
.
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7.5 Does the study require any investigations or interventions to
conducted on patients or other humans or animals? If so, please describe briefly
Not required
be
7.6 Has ethical clearance been obtained from your institution in case of 7.5?
Yes (Copy enclosed).
7.7 Duration of study:
18 months (1st December 2012 to 31st May 2014).
8. LIST OF REFERENCES:
1) Waldmann A, Nolte S, Geller AC, et al. Frequency of Excisions and Yields of
Malignant Skin Tumors in a Population-Based Screening Intervention of 360 288
Whole-Body Examinations. Arch Dermatol. 2012;148(8):903-910.
2) Adinarayan M, Krishnamurthy SP. Clinicopathological evaluation of nonmelanoma
skin Cancer. Indian J Dermatol 2011; 56:670-2
3) Deprez M, Uffer S. Clinicopathological features of eyelid skin tumors. A
retrospective study of 5504 cases and review of literature. Am J Dermatopathol.2009
May;31(3):256-62.
4) Nair PS. A clinico-histopathological study of skin appendageal tumors. Indian J
Dermatol Venereol Leprol 2008; 74:550.
5) Scrivener Y, Grosshans E, Cribier B.Variation of basal cell carcinoma according to
gender, age, location and histopathological subtype. Br J Dermatol.2002
Jul;147(1):41-7
6) Garner A, Koornneef L, Levene A, Collin JR. Malignant melanoma of the eyelid
skin: histopathology and behaviour. Br J Ophthalmol. 1985 Mar;69(3):180-6.
7) Wick MR, Goellner JR, Wolfe JT, Su WP. Adnexal carcinomas of the skin. I. Eccrine
carcinomas. Cancer.1985 Sep 1;56(5):1147-62.
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9. Signature of the Candidate
:
Dr. SHASHIKUMAR. S .D.
10. Remarks of the Guide
:
11. Name and Designation of
11.1 Guide
: Dr. H. B. SHASHIDHAR. M. D.
ASSOCIATE PROFESSOR,
DEPARTMENT OF PATHOLOGY,
MYSORE MEDICAL COLLEGE AND
RESEARCH INSTITUTE,
MYSORE.
11.2 Signature of Guide
:
11.3 Head of the Department
11.4 Signature of
Head of the Department
: Dr. A. L. HEMALATHA. M.D., D.C.P.
PROFESSOR AND HEAD,
DEPARTMENT OF PATHOLOGY,
MYSORE MEDICAL COLLEGE AND
RESEARCH INSTITUTE,
MYSORE.
:
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12. Remarks
12.1 Remarks of the Dean
and Director
:
12.2 Signature of the Dean
and Director
:
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ETHICAL COMMITTEE CLEARANCE
1. TITLE OF THE DISSERTATION : “HISTOPATHOLOGICAL STUDY OF
NEOPLASTIC LESIONS OF SKIN AND
ADNEXAE”
2. NAME OF THE CANDIDATE
: Dr.SHASHIKUMAR S.D.
3. SUBJECT
: M.D. PATHOLOGY
4. NAME OF THE GUIDE
: Dr. H.B SHASHIDHAR., M.D.
ASSOCIATE PROFESSOR,
DEPARMENT OF PATHOLOGY,
MYSORE MEDICAL COLLEGE AND
RESEARCH INSTITUTE,
MYSORE.
5. APPROVED/NOT APPROVED
(If not approved, suggestion)
: APPROVED
`
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MEDICAL SUPERINTENDENT
K.R. Hospital,
Mysore.
MEDICAL SUPERINTENDENT
Cheluvamba Hospital,
Mysore.
PROFESSOR AND HEAD
Department of Medicine,
K.R. Hospital, Mysore.
PROFESSOR AND HEAD
Department of Surgery,
K.R. Hospital, Mysore.
MEDICAL SUPERINTENDENT
PKTB Hospital, Mysore.
LAW EXPERT
THE DEAN AND DIRECTOR,
Mysore Medical College and Research Institute,
Mysore
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