Etiology and incidence of chronic ulcers in Blantyre, Malawi

Jim E. Zeegelaar, Aimee C. Stroïnk, Willemyn H. Steketee, William R. Faber, Allard C. van der Wal, Isaac O. O. Komolafe, Charles Dzamalala, Cecilia Chibwana, Johannes F. Wendte, Eduard E. Zijlstra

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BACKGROUND: Little information is available on the incidence and etiology of chronic ulcers in the tropics. Therefore, the incidence and etiology of chronic skin ulcers were assessed in out-patients at the Department of Dermatology and in in-patients at the Departments of Dermatology, Surgery, Medicine, and Pediatrics, Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. METHOD: In a 10-week study period, 44 patients (31 males, 70%) with chronic skin ulcers were diagnosed from 6292 patients seen by the departments involved. RESULTS: The mean age of patients with ulcers was 38 years (range, 9 months to 82 years). The most frequent cause of ulcers was bacterial infection (n=22), followed by malignancy (n=11) and trauma (n=7). CONCLUSION: In contrast with developed countries, venous and diabetic ulcers were uncommon. In addition to bacterial infections, a surprisingly large number of malignancies were found in this study. We speculate that human immunodeficiency virus (HIV) infection, which is seen with a high prevalence at QECH, is a contributing factor. Because of the large number of malignancies, we recommend early histopathologic investigation of chronic ulcers in this part of Africa
Original languageEnglish
Pages (from-to)933-936
JournalInternational Journal of Dermatology
Issue number8
Publication statusPublished - 2006

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