Major dermatological malignancies encountered in the University of Calabar Teaching Hospital, Calabar, southern Nigeria

Abstract

Dermatologic malignancies are among the most common forms of cancer. Sun exposure is the major risk factor in white people, while non-solar factors appear to be the leading risk factor in the darkly pigmented. We examined 162 patients with histologic diagnosis of dermatological malignancy who consulted at the University of Calabar Teaching Hospital, Calabar from January 2000 to December 2009. The 162 patient cases observed during the study represent 12% of all cancers diagnosed within the same period. Squamous cell carcinoma (SCC) was the most common (n = 62; 38.3% followed by Kaposi sarcoma (KS) (n = 33; 30.9%). Others were malignant melanoma (MM) (n = 16; 9.9%), dermatofibrosarcoma protuberans (DFSP) (n = 11; 6.8%), and basal cell carcinoma (BCC) (n = 8; 4.9%). The lower limb was the most commonly afflicted site (n = 82; 48.8%) while the head and neck ranked second (n = 32; 22.0%); 146 patients (90%) were darkly pigmented and 16 (10%) were people with albinism. Some patients with SCC and MM consulted late for curative surgery. Surgery resulted in healing in patients with BCC, while the recurrent rate for DFSP was high. The endemic KS responded to cytotoxic chemotherapy but the result was poor for KS associated with human immunodeficiency virus. The pattern of dermatologic malignancy revealed in this study is different from that of European skin cancer. Health education, early implementation of preventive measures, early consultation, and treatment will improve outcome in our region.