Background: Cutaneous Granulomatous lesions comprises a heterogeneous group of diseases caused by the variety of infectious and non-infectious etiological factors and thus often poses a diagnostic challenge to histopathologist as they show similar histological features. Objective: The present study was aimed at studying the various histo-morphological patterns of cutaneous granulomatous lesions, to determine the relative frequencies and to compare our results with other studies. Materials and Methods: A retrospective analysis of skin biopsies received over a period of three years from January 2016 to November 2018 was performed and cases of cutaneous granulomatous lesions reported on histopathology were analyzed with respect to age, sex, site, and etiology and histomorphological pattern. Results: Out of a total of 516 skin biopsies 45 (8.7%) cases were diagnosed as cutaneous granulomatous lesions. It was common in males (60%) with most occurring in the third to fourth decades. Majority of the cases (28 cases, 62.2%) were categorized as infectious granulomatous lesions with the predominance of leprosy (18 cases, 40%) followed by tuberculosis (7 cases, 15.5%). Conclusion: The present study is a comprehensive, comparative study of cutaneous granulomatous lesions and leprosy is the most common cause of granulomatous skin lesions according to this study. This study concludes that histopathology is the gold standard investigation for diagnosis, categorization, and management of cutaneous granulomatous lesions. Special stains play a supportive role in the diagnosis of infectious granulomas.

Keywords: Cutaneous Granulomatous Lesion; Leprosy; Tuberculosis.