International Journal of Clinical Medicine, 2011, 2, 93-96
doi:10.4236/ijcm.2011.22019 Published Online May 2011 (http://www.SciRP.org/journal/ijcm)
Copyright © 2011 SciRes. IJCM
93
Basal Cell Carcinoma: Experience in a Teaching
Hospital, Calabar-South Nigeria
Maurice Asuquo
1
, Otei Otei
1
, Victor Nwagbara
1
, Godwin Ebughe
2
, Joshua Omotoso
2
1
Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria;
2
Department of Pathology, University of Cala-
bar Teaching Hospital, Calabar, Nigeria.
Email: {mauefas2, onte333, aikay_en, gobeng01, ayomemee}@yahoo.com
Received December 6
th
, 2010; revised December 28
th
, 2010; accepted January 4
th
, 2011.
ABSTRACT
Background: Basal cell carcinoma (BCC) is the commonest malignancy among Caucasians in Europe, North America,
and Australia. This study attempted to identify the prevalence, risk factors, and outcome of management of this problem
in our region. Methods: All the patients with histologic diagnosis of BCC presenting to the University of Calabar
Teaching Hospital, Calabar during the study period January 2000 to December 2009 were evaluated. Results: One
hundred and fifty two patients (136 blacks, 16 albinos) were afflicted with skin malignancy, squamous cell carcinoma
and BCC totaled 70 [SCC-62, BCC-8], and malignant melanoma (MM)-16. Of the 8 patients, (3 males and 5 females,
mean age 43 years, range 21 - 65 years) observed with BCC lesions, 2 (25%) were darkly pigmented and 6 (75%) were
albinos. Most of the albinos who presented 3 decades before the darkly pigmented ranged in age from 21 - 60 years
(mean 35.7 years). The lesions afflicted the head and neck region, 9 (82%), while 2 (18%) were observed on the upper
limb. All the patients had excision with satisfactory results during the period of follow up that ranged from 6 months to
3 years (mean 13 months). Conclusion: BCC is an uncommon lesion in our region. Albinism and solar radiation were
identified risk factors. Most of the albinos presented 3 decades earlier than the darkly pigmented. Early institution of
preventive measures, early diagnosis, and treatment would result in better outcome.
Keywords: Basal Cell Carcinoma, Albinos, Darkly Pigmented
1. Introduction
Basal cell carcinoma (BCC) is undisputedly the com-
monest dermatological malignancy among Caucasians in
Europe, North America, and Australia, occurring typi-
cally in areas of chronic sun exposure, usually slow
growing and rarely metastasize [1,2]. In the United States,
approximately 80% of invasive skin cancers are BCC
while 20% are squamous cell carcinoma (SCC) [3]. Ul-
traviolet radiation (UVR) is the most important risk fac-
tor in the development of BCC [4]. In Africa, Albinism
and environmental exposure to sunlight are established
risk factors for the development of BCC [5]. There are
numerous variations in clinical presentation of BCC such
as nodular BCC, ulcerating BCC, pigmented BCC, scle-
rosing BCC, superficial BCC, and fibroepithelioma of
Pinkus [6]. Despite its very high prevalence, BCC is ge-
nerally a low-grade neoplasm, it can be locally invasive
and destructive rarely metastasizes and amenable to ex-
cision management [7]. We present this study in an at-
tempt to highlight the prevalence, risk factors, and out-
come of treatment of this lesion in our setting.
2. Patients and Methods
All the patients with histologic diagnosis of BCC pre-
senting to the University of Calabar Teaching Hospital
during the study period January 2000 to December 2009
were evaluated as part of a wider study of skin malig-
nancies. The variables analyzed included, age, gender,
number of lesions, clinical presentation, site of lesion,
human immunodeficiency virus (HIV) serology, treat-
ment, outcome, follow up, and skin pigmentation. This
was compared with total number of skin malignancies
and total number of SCC seen during the same period.
3. Results
In total, 152 patients were afflicted with skin malignancy
during the study period (136 blacks, 16 albinos). BCC
accounted for 5% of all skin malignancy, 9% of all epi-
dermal malignancy, and 11% of all non-melanoma skin
cancer. Sixteen albinos (SCC- 9, BCC- 6, and MM- 1)
were seen and accounted for 10.5% of patients with skin