Histomorphologic spectrum of cutaneous keratinocytic tumours: A Five year retrospective study from Zaria,Nigeria.

Background: Cutaneous keratinocytic tumours represent a broad spectrum of benign and malignant skin lesions with diverse histomorphologic features and epidemiological patterns. Despite their clinical significance, there is limited region-specific data from Northern Nigeria, particularly regarding their distribution and morphological characteristics. Objective: This study aimed to evaluate the histomorphologic spectrum and demographic distribution of cutaneous keratinocytic tumours in Zaria, Nigeria, over a five-year period. Methods: A retrospective cross-sectional study was conducted at the Department of Anatomical Pathology, Ahmadu Bello University Teaching Hospital, Zaria, from January 2018 to December 2022. Archived haematoxylin and eosin-stained slides and formalin-fixed paraffin-embedded tissue blocks of histologically diagnosed cases were reviewed. Relevant clinical and demographic data, including age, sex, and tumour location, were extracted and analyzed using SPSS version 20. Results: A total of 182 cases were included, comprising 137 (75.3%) malignant and 45 (24.7%) benign tumours. There was a slight male predominance with a male-to-female ratio of 1.3:1. The age of patients ranged from 3 to 84 years, with a mean age of 43.4 years, and peak incidence observed in the fifth and seventh decades. Squamous cell carcinoma was the most common tumour, accounting for 67.0% of cases, followed by basal cell carcinoma (5.5%). Among benign lesions, verrucae were most frequent (20.9%). The head and neck region was the most commonly affected anatomical site (42.9%), reflecting a predilection for sun-exposed areas. Conclusion: Cutaneous keratinocytic tumours in this setting are predominantly malignant, with squamous cell carcinoma as the leading subtype. The findings highlight the need for increased public health awareness, early detection strategies, and improved access to diagnostic and treatment services to reduce the burden of advanced skin cancers in this population.