The Skin Is Emperor of All Diseases': Prof Ngbea Urges Sun Exposure for Vitamin D Production.
A Professor of Anatomical Pathology at Rev. Fr. Moses Orshio Adasu University, Makurdi, Prof. Joseph Aondowase Ngbea, has described the skin as the “emperor of all diseases,” urging Nigerians to get safe sun exposure to boost Vitamin D production and prevent illnesses.
Delivering the university’s 25th Inaugural Lecture titled, “THE HUMAN SKIN: A Transition from a Physiologic Integument to a Clinicopathologic Emperor of All Diseases,” Prof. Ngbea said the skin mirrors pathologic changes in almost every disease, which justifies calling it the “emperor of all diseases.”
He noted that the skin plays a central role in immunity, protection, and overall 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 described Vitamin D as “a fat-soluble vitamin that functions more like a hormone,” tracing its production from sunlight to liver and kidney activation and linking it to the wider diagnostic role of the skin.
Prof. Ngbea explained the pathway: when UVB rays strike the epidermis, 7-dehydrocholesterol is converted to pre-vitamin D3 and then to vitamin D3.
The liver converts it to 25-hydroxyvitamin D, the storage form, while the kidney activates it to 1,25-dihydroxyvitamin D, the biologically active hormone that binds to receptors in target tissues.
He noted what he called “Africa’s sunshine paradox,” where despite abundant sunlight, Vitamin D status and related skin pathology remain clinically significant.
The Pathologist said he began his medical journey at Government Secondary School, Gboko in 1982 and earned his MBBS from the University of Jos in 2000.
Though initially inclined toward surgery, he chose Anatomic Pathology because of Nigeria’s critical shortage of pathologists.
He completed his FMCPath in 2012 at Jos University Teaching Hospital, joined Benue State University in 2012, and was promoted to Professor on October 1, 2021. He is the first Professor of Anatomic Pathology of Benue extraction and the first inaugural lecturer of the college of Health Sciences.
He also served as Benue State Commissioner for Health and Human Services from 2020 to 2023.
Key research findings:
Drawing from his Fellowship dissertation in Jos, Prof. Ngbea reported that skin disease affects up to 90 to 98 percent of people living with HIV, with the highest burden seen in 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. Psoriasis, molluscum contagiosum and Kaposi sarcoma were among the most frequent patterns documented in Jos in 2012, findings he said were mirrored in a 2018 review of dermatological malignancies in Makurdi.
He added that with antiretroviral therapy and viral load suppression, “we don’t see these angry-looking, ugly skin lesions as in the past,” even though Benue remains one of the states with the highest HIV prevalence in Nigeria at 5.3 percent.
The lecture also highlighted a case of a 10-year-old with fungating nasal and facial lesions initially treated as fungal infection, later confirmed on biopsy as cutaneous tuberculosis, Lupus Vulgaris, which resolved after three months of anti-TB therapy.
In a review of 236 cases of extrapulmonary TB at Benue State University Teaching Hospital, he noted presentations ranging from lymphadenopathy to fungating skin lesions.
On women’s cancers, Prof. Ngbea said breast and cervical cancers remain the leading causes of cancer deaths among women in developing countries.
"In Nigeria, breast, cervix, prostate, colorectal, liver and non-Hodgkin lymphoma are the six most common cancers, with breast cancer predominating in Makurdi, typically in women in their 40s and 50s".
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His PhD work on Immunohistochemical Patterns of Invasive Ductal Carcinoma in Makurd, found triple negative breast cancer, ER-, PR-, HER2/neu-, at about 60 percent, far higher than the global rate of 10 to 20 percent.
In a five-year review, 2012 to 2017, of 202 gynaecological malignancies at BSUTH, 128 cases, or 63.4 percent, were cervical cancers, with squamous cell carcinoma as the dominant type.
He stressed that early detection through mammography and Pap smear is still low, leaving many patients to present at advanced stages.
Recommendations:
Prof. Ngbea called for urgent investment in pathology services, including: Establishing Immunohistochemistry at BSUTH, which he said is critical for breast cancer and lymphoma diagnosis and treatment decisions.
He stressed the need to encourage subspecialisation in Anatomic Pathology to improve diagnostic expertise; Stronger synergy between dermatologists, pathologists and other specialties.
The don called for University support for journal publications and book authorship, and Staff motivation, citing his 2024 MPA thesis which found hospital loans, promotions, training and allowances poorly implemented at BSUTH.
Prof. Ngbea holds MBBS, MHM, MPA, PGD Forensic Pathology and Sexology, PhD, FMCPath and other fellowships.
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