Squamous Cell Carcinoma in South-Eastern Equatorial Rain Forest in Calabar, Nigeria

Background: In North America and Europe, 80% of invasive skin cancers are basal cell carcinoma while 20% are squamous cell carcinoma (SCC). In contrast, African studies reveal a preponderance of SCC. Risk factors are grouped into solar and nonsolar. Oculocutaneous albinism (OCA) is a known risk factor for skin cancer in Africans. Their contributions vary with race and geographic region. This study sought to evaluate the pattern, risk factors, and outcome of management of this lesion in our setting. Method: All the patients with histologic diagnosis of SCC between January 2006 and December 2007 were prospectively studied as part of the wider study of skin cancers. Results: The 19 patients (12 males and 7 females) whose ages ranged between 16 and 70 years (mean = 46.2 years) accounted for 51.4% of skin malignancies. Marjolin's ulcers were recorded in 12 patients (63.2%) while 7 patients (36.8%) were non-Marjolin's including 2 OCA patients. The limb was the commonest site involved (57.9%). The outcomes were poor in some cases because of late presentation after topical treatment. Conclusion: Chronic ulcers, inflammation, and albinism were identified predisposing factors. Public health education on prevention, early presentation, and surgical evaluation of chronic ulcers would improve outcome.