…Don Warns Nigerians: Your Skin Is Body’s First Defence
Professor of Anatomical Pathology at Rev. Fr. Moses Orshio Adasu University, Makurdi, Prof. Joseph Aondowase Ngbea, has urged Nigerians to embrace safe exposure to sunlight, saying about 15 minutes of daily sun exposure can support Vitamin D production and contribute to overall health.
Ngbea gave the advice while delivering the university’s 25th Inaugural Lecture titled, “The Human Skin: A Transition from a Physiologic Integument to a Clinicopathologic Emperor of All Diseases.”
The professor described the skin as the “emperor of all diseases,” explaining that it reflects pathological changes associated with several diseases and plays critical roles in immunity, protection and general wellbeing.
“The skin is the emperor of all diseases, that is why you must expose it to sun. When it is unhealthy, the whole body suffers,” he said.
According to him, Vitamin D is a fat-soluble vitamin that functions more like a hormone and plays an important role in the body’s biological processes.
He explained that when ultraviolet B (UVB) rays from sunlight strike the epidermis, 7-dehydrocholesterol is converted into pre-vitamin D3 and subsequently into Vitamin D3.
The liver then converts it into 25-hydroxyvitamin D, the body’s storage form, while the kidney activates it into 1,25-dihydroxyvitamin D, the biologically active hormone that binds to receptors in target tissues.
Ngbea, however, highlighted what he described as “Africa’s sunshine paradox,” noting that despite the continent’s abundant sunshine, Vitamin D status and skin-related diseases remain clinically significant.
The pathologist also traced his medical journey to Government Secondary School, Gboko, where he began his education in 1982 before obtaining his MBBS degree from the University of Jos in 2000.
Although he initially intended to specialise in surgery, he opted for Anatomical Pathology because of what he described as the critical shortage of pathologists in Nigeria.
He obtained his FMCPath from the Jos University Teaching Hospital in 2012, joined Benue State University the same year and was promoted to the rank of professor on October 1, 2021.
Ngbea is the first Professor of Anatomic Pathology of Benue extraction and the first inaugural lecturer of the institution’s College of Health Sciences.
He also served as Benue State Commissioner for Health and Human Services from 2020 to 2023.
Skin Disease, HIV and Tuberculosis
Drawing from his fellowship dissertation in Jos, Ngbea disclosed that skin diseases affect between 90 and 98 per cent of people living with HIV, with the highest burden among patients with CD4 counts below 200 cells/mm³ and viral loads above 10,000 copies/mL.
He classified common HIV-related skin manifestations into hypersensitivity reactions, infections and infestations, and neoplasms.
According to him, psoriasis, molluscum contagiosum and Kaposi sarcoma were among the frequent patterns documented in Jos in 2012, findings he said were also reflected in a 2018 review of dermatological malignancies in Makurdi.
He noted that the situation had improved significantly with the widespread use of antiretroviral therapy and viral-load suppression.
“With antiretroviral therapy and viral load suppression, we don’t see these angry-looking, ugly skin lesions as in the past,” he said.
Ngbea noted that Benue remains one of the states with a high HIV prevalence in Nigeria, putting the figure at 5.3 per cent.
He also presented the case of a 10-year-old child who developed fungating lesions around the nose and face. The condition was initially treated as a fungal infection but was later diagnosed through biopsy as cutaneous tuberculosis, or Lupus Vulgaris.
According to him, the lesions resolved after three months of anti-tuberculosis treatment.
In a review of 236 cases of extrapulmonary tuberculosis at Benue State University Teaching Hospital, he said patients presented with different manifestations ranging from lymphadenopathy to fungating skin lesions.
Breast, Cervical Cancer Burden
The inaugural lecturer also drew attention to the burden of breast and cervical cancers, describing them as major causes of cancer deaths among women in developing countries.
He said breast, cervical, prostate, colorectal, liver and non-Hodgkin lymphoma were among the six most common cancers in Nigeria, with breast cancer predominating in Makurdi, particularly among women in their 40s and 50s.
Ngbea disclosed that his PhD research on the immunohistochemical patterns of invasive ductal carcinoma in Makurdi found triple-negative breast cancer — ER-negative, PR-negative and HER2/neu-negative — in about 60 per cent of cases studied.
He noted that the figure was considerably higher than the estimated global rate of 10 to 20 per cent.
A five-year review of 202 gynaecological malignancies at the Benue State University Teaching Hospital between 2012 and 2017, he said, recorded 128 cases, representing 63.4 per cent, as cervical cancers, with squamous cell carcinoma being the dominant type.
He stressed that low uptake of early screening, including mammography and Pap smears, continues to contribute to late presentation among cancer patients.
Don Calls for More Investment in Pathology
Ngbea called for urgent investment in pathology services, particularly the establishment of immunohistochemistry facilities at Benue State University Teaching Hospital.
He said the facility would be critical to accurate diagnosis and treatment decisions for diseases such as breast cancer and lymphoma.
He also advocated greater subspecialisation in Anatomical Pathology to improve diagnostic expertise, as well as stronger collaboration among dermatologists, pathologists and other medical specialists.
The professor called for greater university support for academic publications and book authorship, as well as improved staff motivation.
He cited his 2024 Master of Public Administration thesis, which he said found poor implementation of hospital loans, promotions, training and allowances at the teaching hospital.
Ngbea disclosed that he is currently working on an “Atlas of Dermatopathology in the Tropics”, while his future research interests include molecular pathology, immunohistochemical profiles in dermatopathology and immunofluorescence in renal and central nervous system pathology.
Rounding off the lecture, Ngbea urged men to regularly check their blood pressure, describing hypertension as a “silent killer.”
The inaugural lecture formed part of activities marking his formal introduction to the university community, the general public and the wider academic world as a professor.
Prof. Ngbea holds MBBS, MHM, MPA, PGD in Forensic Pathology and Sexology, PhD, FMCPath and other professional fellowships.
