Ignorance and sociocultural factors were underlying issues in delaying treatment. Education highlighting the risk associated with chronic wounds and albinism, and the need for prevention, prompt treatment and proper surgical management, would improve prognosis with a reduction in the healthcare cost of this problem.

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Basosquamous carcinoma (BSC) is a rare malignancy with features of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) with a potential for infiltration and destruction. This is a report of a florid scalp lesion of BSC with erosion of the skull. A preoperative diagnosis of BCC was made following a biopsy. However, further evaluation of the excised lesion revealed BSC. Timely diagnosis of this potentially aggressive neoplasm, which could be enhanced by multiple biopsies, is essential for proper treatment.

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Background: Skin cancers are among the most common form of cancer. In Africa, several reports reveal squamous cell carcinoma (SCC) as the commonest skin malignancy. In Africa, including regions of the same country, there are significant differences in the pattern of skin malignancy. This study sought to evaluate the pattern, risk factors and outcome of management of skin malignancy in our setting. Methods: Patients with histologic diagnoses of skin malignancy from January 2007 and December 2008 who presented to the University of Calabar Teaching Hospital were prospectively studied. Results: Forty-five patients presented with skin malignancy during the study period. The ages of the patients ranged from 5 and 75 years (mean: 46.6 years). The commonest skin malignancy was SCC in 19 (42.2%) patients while Kaposi sarcoma (KS) ranked second 15 (33.3%). Six patients presented with melanoma, two with metastatic carcinoma, basal cell carcinoma (BCC) two patients and a patient with dermatofibrosarcoma protuberans (DFSP). The lower limb was the commonest site involved in 25 (55.6%) patients, while the head and neck 11 (24.4%) ranked second. Conclusion: SCC was the commonest skin malignancy. Non-solar factors of chronic ulcers in SCC, immunosuppression in KS, were identified as possible risk factors in some malignancies. This is at variance with the experience in Caucasians where solar radiation is the predominant risk factor. However, albinism and solar radiation were identified as risk factors in keeping with the Caucasians. Health education strategies on prevention, early presentation, and surgical evaluation of chronic ulcers would improve outcome.