A CLINICO-PATHOLOGICAL STUDY OF CHRONIC ULCERS OF THE FACE

Abstract

This is a study of the incidence of the different histopathological types of chronic ulcers of the face carried out in 20 patients at the Head and Neck Surgery Unit, Faculty of Medicine, Alexandria University. Of these ulcers, 13 were B.C.C, 6 were Sq.C.C, and a case was a non-specific inflammatory ulcer. Data were presented on the different types of chronic facial ulceration with a special reference to the clinical and histopathologic appearance, anatomical site and size of the lesion on referral, the duration prior to referral and the different lines of surgical treatment found appropriate for the specific lesion. In this study males were affected more than females, their ages ranged from 20- 70 years with the highest frequency being in the fifth decade of life. More than 60 % of cases were from rural areas. Prolonged exposure to sunlight and heat in general seemed to be the main predisposing factors. Mostly the lesions occurred in the middle third of the face, specially on the nose, nasolabial fold, cheek, lower and upper eye lids and inner canthi. A significant proportion of patients had sizable lesions on referral ranging from 2 to 4 cm in diameter. The average tumour had been present for 2 to 4 years before treatment. Clinically, scaly crusted, pigmented and cicatrizing ulcers are the presentation of ulcerated B.C.C. whereas, ulcerated Sq.C.C. represent either an endophytic or exophytic growth. Multiple lesions occurred in about 5 % of cases and was a part of xeroderma pigmentosum.