Accepted Abstracts: J Clin Exp Dermatol Res
Chronic cutaneous ulcers are commonplace in the developing world often resulting from trauma of road traffic injuries. Chronic ulcers may also be due to vascular insufficiency, neuropathy, pressure, diabetes, heamoglobinopathies or they may be tropical ulcers. If poorly managed, these lesions may undergo malignant transformation. We evaluated the clinical histories and treatment outcomes of patients who presented to the University of Calabar Teaching Hospital, Calabar from January 2010 to December 2012 with histologic diagnosis of Marjolin?s ulcer. The ages of the 7 patients (4 males, 3 females) ranged from 28-72 years (mean 45.7 years) and they accounted for 46.7% of squamous cell carcinoma (SCC) and 15.9% of total skin malignancy observed during the same period. Trauma, 6(87%) was the leading cause resulting in chronic ulceration, [road traffic injuries, 4 patients, (58%), 2-flame burn (29%)]. The other patient had a diabetic ulcer. Three patients had chronic osteomyelitis as complications of road traffic injuries. Six patients (86%) suffered injuries of the lower limb and one had upper limb injury. The histologic diagnosis in all the cases were SCC with a latency period that ranged from 5-40 years (16.3 years). Four patients were managed with wide local excision and skin grafting; three had amputations (two above knee and one forearm) with uniformly poor results. There was hospital mortality in a patient. Chronic limb ulcerations resulting from traumatic injuries were the leading risk factor and traumatic injuries are preventable. Economic, sociocultural factors and ignorance were notable underlying factors. Health education models adapted to the local environment targeting prevention of injuries, risks associated with chronic wounds, early presentation, and diagnosis are recommended for improved outcome.
Maurice Efana Asuquo upon completion of the Fellowship in Surgery (FWACS) in 2000, he joined the University of Calabar as a lecturer in 2001. Today he is a Professor/Consultant Surgeon, University of Calabar/University of Calabar Teaching Hospital, Calabar, Nigeria. He is a Fellow of the International College of Surgeons (FICS), and served as the Head of Department of Surgery, University of Calabar, Calabar, Nigeria and is the current Dean, Faculty of Medicine and Dentistry. His major research interest is dermatologic malignancy. Attended several International and Local conferences and presented several papers on dermatologic oncology. He pioneered research resulting in several publications on dermatologic malignancy: Basal cell carcinoma in five albinos from the south-eastern equatorial rain forest in Nigeria (Asuquo et al 2007), Marjolin?s ulcer: the importance of surgical management of chronic cutaneous ulcers (Asuquo et al 2007), Dermatofibrosarcoma protuberans: Case reports (Asuquo et al 2007), Kaposi sarcoma: Changing trend in Calabar (Asuquo et al 2008), Skin malignancies in Calabar (Asuquo et al 2009), Cutaneous metastatic carcinoma: Diagnostic and Therapeutic values (Asuquo et al 2010). Others include Skin cancer in four Nigerian albinos (Asuquo et al 2009), Cutaneous squamous cell carcinoma in Calabar, Southern Nigeria (Asuquo et al 2009), Marjolin?s ulcer: Therapeutic Challenges (Asuquo et al 2010) and Squamous cell carcinoma of the skin: clinical pattern and challenges of treatment (Asuquo et al 2011). Malignant adnexal tumours: diagnostic and therapeutic challenges in Calabar, Nigeria (Asuquo et al 2012), Cutaneous malignant melanoma in Calabar, South Nigeria (Asuquo et al 2012), Major dermatological malignancies encountered in the University of Calabar Teaching Hospital, Calabar, South Nigeria (Asuquo et al 2012), and Oculocutaneous albinism and skin cancer in Calabar, South Nigeria (Asuquo et al 2013).