Superficial skin ulcers

OBJECTIVE: To determine the underlying cause of superficial skin ulcers over a 15-year period.

METHODS: A retrospective histopathological analysis of 670 cases of superficial skin ulcers diagnosed in the Department of Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria from January 1991 to December 2005.

RESULTS: A total of 670 superficial skin ulcers were analyzed. The male to female gender ratio was 409:261(1.5:1.0) and a peak age frequency of 44.3% (297) in the 5th and 6th decades. Spectrum of lesions encountered was categorized into inflammatory, infections, benign and malignant diseases. The malignant lesions were 309 (46.1%), non-specific inflammation 302 (45.1%), granulation tissue 25 (3.7%) and pseudoepitheliomatous hyperplasia 14 (2.1%). A total of 18 (2.7%) specific infections were encountered, which included bacterial, fungal and viral infection. Benign lesions were 2 (0.3%), comprising of neurofibroma and Bowen's disease. The most common malignant lesion was squamous cell carcinoma 203 (30.3%) with a male to female ratio of 128:75 (1.7:1.0). Of these, 161 were well-differentiated tumors. The lower limb was the prevalent site distribution of all the ulcers.

CONCLUSION: Superficial ulcers may be harbinger of malignant diseases. Squamous cell carcinoma remains the most common malignant lesion arising from chronic superficial ulcers in our setting. Adequate tissue biopsy and early diagnosis may reduce the attendant morbidity of these ulcers.