Histological review of skin cancers in African Albinos: a 10-year retrospective review

Abstract

BackgroundSkin cancer is rare among Africans and albinism is an established risk for skin cancer in this population. Ultraviolet radiation is highest at the equator and African albinos living close to the equator have the highest risk of developing skin cancers.MethodsThis was a retrospective study that involved histological review of all specimens with skin cancers from African albinos submitted to The Regional Dermatology Training Center in Moshi, Tanzania from 2002 to 2011.ResultsA total of 134 biopsies from 86 patients with a male to female ratio of 1:1 were reviewed. Head and neck was the commonest (n = 75, 56.0%) site affected by skin cancers. Squamous cell carcinoma (SCC) was more common than basal cell carcinoma (BCC) with a ratio of 1.2:1. Only one Acral lentiginous melanoma was reported. Majority (55.6%) of SCC were well differentiated while nodular BCC (75%) was the most common type of BCC.ConclusionsSquamous cell carcinoma is more common than basal cell carcinoma in African albinos.

Dermatopathology in sub‐Saharan Africa: a systematic 5‐year analysis of all histopathological diagnoses from the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania

“…Persons with albinism (PWAs) and xeroderma pigmentosum patients also contribute to the high prevalence of epithelial skin cancers observed in this region of Africa and further affect the relative distribution of SCC and BCC . The implementation of a successful comprehensive albino care programme at the RDTC lead in recent years to an improved diagnosis and management of skin cancers in this risk group . In western countries 80% of epithelial tumours are BCC and 20% SCC, however, in PWAs this ratio is inverted, influencing also our data.…”

Multiple basal cell carcinomas in a patient of oculocutaneous albinism

“…revealed almost identical proportion of squamous cell carcinomas and basal cell carcinomas in African albinos. [5] Our patient had all features consistent with photodamage such as freckles, actinic keratosis, malignant lesions, predominantly affecting the photo-exposed parts of the body with histopathology consistent with basal cell carcinoma.…”

Cutaneous malignant melanoma incidences analyzed worldwide by sex, age, and skin type over personal Ultraviolet-B dose shows no role for sunburn but implies one for Vitamin D3

“…Like whites, albino blacks get the same UV-induced DNA damage that keratinocytes accumulate, as shown by their higher rates of non-melanoma skin cancer at younger ages, but those DNA lesions do not transform their melanocytes. The fact that all 4 types of albinos, OCA1 (A&B), OCA2, OCA3, and OCA4 have drastically reduced production of melanin and its precursors 76 and have an almost non-existent incidence of CMM suggests that either melanin or its precursors are probably required for initiating melanoma. Strong evidence that melanoma initiation relies upon melanin content comes from the fact that the action spectrum for melanoma in a fish model (Xiphophorus) is identical to the action spectrum for photosensitized radicals that are only produced by the pigmented fish 77 …”