Analysis of cutaneous biopsies could yield data on the presentation and occurrence of skin diseases in a population. We undertook a descriptive cross-sectional study of cutaneous biopsy specimens received in our practice, aiming to document the pattern of practice and the range of underlying causative pathologies in skin biopsies of a black African population. A search of our digital archives was conducted and histopathology reports and requisition forms of all skin biopsy cases accessioned between January 1, 2000, and December 31, 2018, were identified. Data were extracted and analyzed. Skin biopsies constituted 10% (2687/26745) of all surgical specimens. Out of the 2547 biopsies included in the study, 62.5% (1602/2547) came from surgery specialities (general, plastic and paediatric surgery) while 37.1% (945/2547) came from the dermatology department. The techniques of biopsy done were excision (63.4% of all biopsies); incision (0.6%); and punch (36%). 126 pathologies were diagnosed. The most frequent pathology was squamous cell carcinoma (7.9% of all biopsies) followed by epidermoid cyst (4.9%) and psoriasis (4.6%). 25 diseases entities accounted for 70.4% of all diagnoses. 176 different disease entities were the underlying cause of all the biopsies and only 25 of these accounted for over 70% of all diagnoses. Surgeons submitted more cutaneous biopsies than dermatologists did. There was a strong association between groups of dermatological disease, the technique of biopsy and attending speciality.
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