[Squamous cell carcinoma on a leg ulcer in the West Indies].
BACKGROUND
The epidemiology of carcinoma developing on a leg ulcer is poorly, although high incidence rates are reported in Africa.


METHODS
Retrospective study of cases reported in Guadeloupe, a tropical country with a large population from African descent and with high quality health care level.


RESULTS
Sixteen cases, mean age 71, were diagnosed over a 10-Year period in the only referral hospital. The annual incidence was an estimated 0.4/100,000. Preceding ulcers had a long course (mean of 27 Years) and had various causes. Social distress was the rule (14/16 patients). One third of the clearly differentiated (15/16) squamous cell-type tumors exhibited metastatic extension on presentation. At Year 3, the mortality rate was of 40 p. cent. The best survival rate (6 remissions/8 cases) was associated with primary limb amputation.


CONCLUSIONS
Malignant ulcers appeared more frequent in Guadeloupe than in the influent countries of the North, but with an instance 4-fold lower than in Africa. Like many other tropical diseases, socio-behavioral factors may play a major role.
Muller
P
P
Service de Dermatologie et Maladies Infectieuses, Centre Hospitalier Universitaire, Pointe à Pitre, Guadeloupe. philippe.muller@chu-guadeloupe.fr
Roul
S
S
Mahe
A
A
Roudier
M
M
Vaque
D
D
Strobel
M
M
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications*; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000150:complications*; D014900:West Indies