HISTOPATHOLOGICAL PATTERNS OF SKIN CANCER IN JOS UNIVERSITY TEACHING HOSPITAL, JOS NORTH CENTRAL NIGERIA

Abstract

Background: The world over, dermatological malignancies are among the most common form of cancer and their prevalence is on the rise. This is because of excessive exposure to ultraviolet rays of the sun consequent on the depletion of the ozone layer and non-solar factors such as chronic ulcers and immunosuppression. Objective: The aim of this study was to determine the histopathological pattern of skin cancers in the Jos University Teaching Hospital, Jos. Method: This was a histopathological analysis of two hundred and twenty-nine cases of skin cancer seen and diagnosed in the Department of Histopathology, Jos University Teaching Hospital, Jos from January 2004 to December 2013. The specimens were fixed in formalin, processed in paraffin wax and stained with haematoxylin and eosin. The slides were studied and the lesions were characterised. Immunohistochemical antibodies were applied to cases that diagnoses were inconclusive on haematoxylin and eosin stain. Results: Two hundred and twenty-nine skin cancers representing 11.7% of 2427 malignant tumours seen within the study period were analysed. This comprised of 133 males and 96 females. Squamous cell carcinoma (SCC) was the commonest and constituted 44.5% made up of 94.1% well differentiated lesions and 5.9% moderately differentiated cases. 15.7% were acantholytic SCC, 76.5 were spindle cell variant and 7.8% were verrucous SCC. 72 SCC cases emanated from a pre-existing chronic ulcer, 4 cases from burn scar and 26 occurred de novo. Basal cell carcinoma constituted 0.9% of all cases. Malignant Melanoma made up 18.8%; of which 74.4% were nodular melanoma, 16.3% were desmoplastic melanoma, 7.0% were persistent melanoma and 2.3% were lentigo maligna variant of melanoma. 95.3% were melanotic melanoma and 4.7% were amelanotic melanoma. Appendageal tumours included Porocarcinoma which constituted 1.3%, primary cutaneous Adenoid cystic carcinoma 0.4% and Hidradenocarcinoma 0.4%. Dermatofibrosarcoma protuberans accounted for 4.8% and Kaposi sarcoma 28.8%. 97.0% of the Kaposi sarcoma cases were HIV seropositive while 3.0% were HIV seronegative. Overall, the male to female ratio was 1.4:1. The peak age range of occurrence was in the fourth decade of life. The lower limb was the most affected site which accounted for 55.9% of the sites involved. Conclusion: Dermatological malignancies are common in our environment and the commonest was squamous cell carcinoma. Prompt and adequate wound care as well as control of Human Immunodeficiency Virus infection would help to reduce the burden of these cancers.

Key Words; Skin Cancer, SCC, KS, Jos

HISTOPATHOLOGICAL PATTERNS OF SKIN CANCER IN JOS UNIVERSITY TEACHING HOSPITAL, JOS NORTH CENTRAL NIGERIA