Dermatological malignancies at a University teaching Hospital in Northwestern Tanzania: A retrospective review of 154 cases

Abstract

Dermatological malignancies are among the most common form of cancers and the global incidence has been increasing at an alarming rate. A retrospective study was conducted to determine the prevalence, histopathological pattern, anatomical distribution and treatment outcome of dermatological malignancies at Bugando Medical Centre in North-western Tanzania. Data were collected from patients' files kept in the Medical record department; the surgical wards, operating theatre and histopathology laboratory and analyzed using Statistical package for social sciences system. A total of 154 patients with a histopathological diagnosis of dermatological malignancy were studied. Generally, males outnumbered females by a ratio of 1.4:1. The majority of patients were in the 5th and 6th decades of life. Malignant melanoma was the most common dermatological malignancy (67.5%) followed by Kaposi's sarcoma (10.4%), Squamous cell carcinoma (8.4%) and Basal cell carcinoma(7.8%). The lower limbs were the most frequent site accounting for 55.8%. Wide local excision was the most common surgical procedure performed in 79.2% of cases. Post-operative wound infection was the most common complication in 58.3% of patients. Mortality rate was 3.8%. Dermatological malignancies are more prevalent in our setting. A high index of suspicion is needed to avoid labelling malignancies "chronic ulcers" and all suspected lesions should be biopsed. ______________________________________________________________________________

Primary cutaneous malignancies in the Northern Cape Province of South Africa: A retrospective histopathological review

“…SCC and KS are reportedly the most common cutaneous malignancies in black individuals, which may explain why these pathologies accounted for most skin cancer in the public sector. [31,32] Poorly differentiated SCC occurred in a higher percentage of black and coloured individuals than white individuals. Poorly differentiated subtypes have a poorer prognosis and tend to be seen in patients who have presented late, once the tumour is already advanced.…”

Dermatologic neoplasms: a perspective from Makurdi, North Central Nigeria

“…7,16,17 However, studies in Calabar documented that Kaposi Sarcoma was the commonest malignancy, while melanomas were the most frequent in Benin and Tanzania. 6,12,15 In addition basal cell carcinomas were the most common skin malignancy in the United States, China and Egypt, while they accounted for only 7.1% of cancers diagnosed in this study. 18,19 These variations are due to difference in skin types amongst the different racial groups.…”

“…This contrasts findings in Oshogbo (1.6:1) and Tanzania (1.4:1). 5,12 Notably, Kim et al postulated that a higher incidence in male sex, of skin cancers was a sequel to greater involvement in outdoor activities such as farming, fishing and manual labour. 13 There's an increased involvement of the female sex in such activities in Makurdi, as well as a higher consciousness of the cosmetic effects of skin lesions in the female sex.…”

“…This correlates with findings in Kano, Benin and Tanzania. 7,12,15 Lower limbs are usually exposed to UV radiation from the sun and are also a frequent site of chronic ulcerative lesions, which are a common precursor of skin malignancies. The paucity of lesions on the trunk and groin can be attributed to limited UV exposure and lower occurrence of trauma in comparison to the limbs.…”

“…The use of protective footwear has been suggested to reduce the incidence of skin cancers in some tropical regions. 12 Going by the level of poverty in this environ and the aetiologic factors listed above, it can be assumed that the cancers seen represent a small proportion of the actual cases present in Benue. Considering the prohibitive costs of managing advanced staged skin malignancies, it is essential that a multi-pronged approach of education campaigns, screening and treatment of suspicious lesions would be instrumental in reducing the burden of this disease.…”