Histopathologic patterns of cutaneous malignancies in individuals with oculocutaneous albinism in Anambra state, Nigeria: a paradigm swing?

BACKGROUND: A high proportion of skin cancers in Nigeria occur in Individuals with oculocutaneous albinism (OCA). A reduction or absence of melanin, a skin pigment with photoprotective properties, makes them susceptible to skin malignancies such as squamous cell carcinomas (SCCs), basal cell carcinomas (BCCs) and rarely melanomas. Globally, BCCs are the commonest cutaneous malignancies among Caucasians and in fair-skinned Africans. This has been attributed to the greater effect of melanin in protecting against UV damage in the basal layer of the epidermis. Older retrospective studies on African albinos suggested that SCCs accounted for a higher prevalence of skin cancers in albinos, followed by BCCs. Melanoma has been consistently documented to be rare in all of these reports. Recent reports however noted BCCs to occur at an increasing frequency, suggesting a higher frequency than previously documented. These conflicting reports reflect the need to re-explore the pattern of cutaneous malignancies in albinos in order to reconcile the role of pigmentation, UV exposure and the variance between the frequencies of the different keratinocyte skin cancers among extreme skin phenotypes. This study explores the pattern of cutaneous malignancies seen in albinos in South East Nigeria. OBJECTIVE: To determine the pattern of cutaneous malignancies among albinos in Anambra state, Nigeria. MATERIALS AND METHODS: A cross-sectional study conducted in Anambra State, Nigeria. Ninety albinos from the Albino foundation Anambra state were recruited. Malignant dermatoses were characterized clinically and confirmed by histology. Fifty-eight lesions from 30 albinos were biopsied to determine the presence of malignancy. RESULTS: Skin cancers were seen in 20.98% of all participants and in 18 (60%) of all the albinos who had skin biopsy. The SCC/BCC ratio was 1.0: 2.3. There was no cutaneous melanoma. CONCLUSION: Contrary to previous reports, it would appear that the pattern of cutaneous malignancies in albinos shows the same trend as that seen in Caucasians and fair-skinned Africans.