University Clinic for Dermatology, Inselspital - Bern University Hospital, Bern, Switzerland.
Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College, Moshi, Tanzania.
J Eur Acad Dermatol Venereol. 2015 Jul;29(7):1370-5. doi: 10.1111/jdv.12877. Epub 2014 Dec 2.
Proper 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.
To investigate the spectrum of dermatopathological diagnoses made in a sub-Saharan African reference centre of a large, mainly rural area.
PATIENTS/METHODS: To retrospectively evaluate all dermatopathological diagnoses made over a period of 5 years at the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania.
There 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.
In 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.
皮肤病的正确诊断依赖于皮肤科最重要的诊断技术——皮肤病理学。遗憾的是，撒哈拉以南非洲地区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。
调查在撒哈拉以南非洲一个大型以农村为主地区的参考中心进行的皮肤病理学诊断范围。
患者/方法：对坦桑尼亚莫希地区区域皮肤科培训中心（RDTC）在 5 年内进行的所有皮肤病理学诊断进行回顾性评估。
共有 1554 例皮肤活检标本。45%的病例为炎症性疾病，最常见的是苔藓样病变。皮肤肿瘤占所有诊断的 30.4%，其中卡波西肉瘤（KS）和鳞状细胞癌（SCC）是两种最常见的肿瘤性疾病。后者还反映了 RDTC 对白化病患者的密集管理。组织学诊断的分布似乎与 RDTC 管理的皮肤病的整体临床谱相关。
在这项非洲研究中，炎症性疾病是导致诊断性活检的主要皮肤病负担。我们的发现进一步证明，KS 主要与 HIV 感染的高流行率有关，是一个流行病学问题。SCC 和基底细胞癌代表了另一种相对常见的恶性皮肤肿瘤，反映了特定高危人群的存在。在这种特定的非洲环境中，具有基本工作条件的挑战性组织学诊断表明，迫切需要开发良好标准的实验室服务和皮肤病理学的具体培训。
