title: Dermatopathology in sub-Saharan Africa: a systematic 5-year analysis of all histopathological diagnoses from the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To investigate the spectrum of dermatopathological diagnoses made in a sub-Saharan African reference centre of a large, mainly rural area.
  
  
  METHODS
  To retrospectively evaluate all dermatopathological diagnoses made over a period of 5 years at the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University Clinic for Dermatology, Inselspital - Bern University Hospital, Bern, Switzerland.|Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College, Moshi, Tanzania.
authors.forename: H
authors.initials: H
authors.lastname: Beltraminelli
authors.affiliation: Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College, Moshi, Tanzania.|Department of Dermatology, Provincial General Hospital, Kakamega, Kenya.
authors.forename: S
authors.initials: S
authors.lastname: Kiprono
authors.affiliation: Pathology Department, University of Nairobi, Nairobi, Kenya.
authors.forename: D
authors.initials: D
authors.lastname: Zuriel
authors.affiliation: Pathology Department at the Kilimanjaro Christian Medical University College, Moshi, Tanzania.
authors.forename: B
authors.initials: B
authors.lastname: Swai
authors.affiliation: University Clinic for Dermatology, Inselspital - Bern University Hospital, Bern, Switzerland.|Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College, Moshi, Tanzania.
authors.forename: E
authors.initials: E
authors.lastname: Giabbani
authors.affiliation: Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College, Moshi, Tanzania.
authors.forename: H
authors.initials: H
authors.lastname: Grossmann
authors.affiliation: Regional Dermatology Training Centre at Kilimanjaro Christian Medical University College, Moshi, Tanzania.
authors.forename: J E
authors.initials: JE
authors.lastname: Masenga
mesh_terms: D001706:Biopsy; D003880:Dermatology / Q000193:education / Q000379:methods*; D006801:Humans; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000175:diagnosis*; D013636:Tanzania