Dermatopathology in sub-Saharan Africa: a systematic 5-year analysis of all histopathological diagnoses from the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania
Dermatopathology in sub-Saharan Africa: a systematic 5-year analysis of all histopathological diagnoses from the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania
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DOI：
10.1111/jdv.12877
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发表时间：
2015-07-01
影响因子：
9.2
通讯作者：
Masenga, J. E.
中科院分区：
文献类型：
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作者：
Beltraminelli, H.;Kiprono, S.;Masenga, J. E.
背景皮肤病的正确诊断依赖于皮肤病理学，这是皮肤病学中最重要的诊断技术。不幸的是，撒哈拉以南非洲的皮肤病理学机构很少，对观察到的组织病理学特征的范围知之甚少。目的调查撒哈拉以南非洲一个大的、主要是农村地区的参考中心所做的皮肤病理学诊断的范围。患者/方法回顾性评估莫希地区皮肤病学培训中心 (RDTC) 5 年来所做的所有皮肤病理学诊断，坦桑尼亚。结果共有1554个皮肤活检标本。 45% 的病例患有炎症性疾病，最常见的是苔藓样疾病。皮肤肿瘤占所有诊断的 30.4%，卡波西肉瘤 (KS) 和较少见的鳞状细胞癌 (SCC) 是两种最常见的肿瘤疾病。后者也反映了 RDTC 对白化病患者的集中管理。组织学诊断的分布似乎与 RDTC 管理的皮肤疾病的总体临床谱相关。结论在这项非洲研究中，炎症状况是导致诊断性活检的皮肤疾病的主要负担。我们的研究结果提供了进一步的证据，表明 KS 主要与 HIV 感染的高流行有关，是一个流行病学问题。鳞状细胞癌和基底细胞癌都是另一种相对常见的恶性皮肤肿瘤，反映了特定人群的存在风险。在具有基本工作条件的非洲特定环境中观察到的具有挑战性的组织学诊断谱表明，迫切需要开发良好标准的实验室服务和皮肤病理学的专门培训。
BackgroundProper diagnosis of skin diseases relies on dermatopathology, the most important diagnostic technique in dermatology. Unfortunately, there are few dermatopathology institutions in sub-Saharan Africa, where little is known about the spectrum of histopathological features observed.ObjectivesTo investigate the spectrum of dermatopathological diagnoses made in a sub-Saharan African reference centre of a large, mainly rural area.Patients/MethodsTo retrospectively evaluate all dermatopathological diagnoses made over a period of 5 years at the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania.ResultsThere were a total of 1554 skin biopsy specimens. In 45% of cases, there were inflammatory diseases, most frequently lichenoid conditions. Cutaneous neoplasms represented 30.4% of all diagnoses, with Kaposi's sarcoma (KS) and, less frequently, squamous cell carcinoma (SCC) being the two most common neoplastic conditions. The latter also reflected the intensive management of persons with albinism in the RDTC. The distribution of histological diagnoses seemed to correlate with the overall clinical spectrum of cutaneous diseases managed in the RDTC.ConclusionsIn this African study inflammatory conditions are the main burden of skin diseases leading to a diagnostic biopsy. Our findings provide further evidence that KS, primarily related to the high prevalence of HIV infection is an epidemiological problem. Both SCC and basal cell carcinoma represent another relatively common malignant cutaneous neoplasms, reflecting the presence of specific populations at risk. The challenging spectrum of histological diagnoses observed in this specific African setting with basic working conditions shows that development of laboratory services of good standards and specific training in dermatopathology are urgently needed.