Skin cancers in albinos in a teaching Hospital in eastern Nigeria - presentation and challenges of care
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RESEARCH
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
Skin cancers in albinos in a teaching Hospital in eastern Nigeria - presentation and challenges of care Kingsley O Opara*, Bernard C Jiburum
Abstract Background: Albinism is a genetic disorder characterized by lack of skin pigmentation. It has a worldwide distribution but is commoner in areas close to the equator like Nigeria. Skin cancers are a major risk associated with albinism and are thought to be a major cause of death in African albinos. Challenges faced in the care of these patients need to be highlighted in order to develop a holistic management approach with a significant public health impact. The aim of the study was to determine the pattern of skin cancers seen in Albinos, and to highlight problems encountered in their management. Method: Case records of albinos managed in Imo state University teaching Hospital from June 2007 to May 2009 were reviewed. The data obtained was analyzed using descriptive statistics. Results and discussion: In the period under review, albinos accounted for 67% of patients managed for primary skin cancers. There were twenty patients with thirty eight (38) lesions. Sixty one percent of the patients were below 40 years. Average duration of symptoms at presentation was 26 months. The commonest reason for late presentation was the lack of funds. Squamous cell carcinoma was the commonest histologic variant. Most patients were unable to complete treatment due to lack of funds. Conclusion: Albinism appears to be the most important risk factor in the development of skin cancers in our environment. Late presentation and poor rate of completion of treatment due to poverty are major challenges.
Introduction Albinism is a genetic disorder characterized by lack of skin pigmentation. Its mode of inheritance is thought to vary, depending on the type. The oculocutaneous type is considered autosomal recessive, and the ocular variant sex linked [1]. Albinism has a worldwide distribution, but is said to be commoner in regions of the world closer to the equator, with greater penetration of the sun’s ultraviolet radiation [2]. It has an estimated frequency of 1 in 20000 in most populations with the highest incidence of 6.3 per 1000 reported among the Cuna Indians [2,3]. In Africa, incidences ranging from 1 in 2,700 to 1 in 10,000 have been reported in various studies [4-7].
* Correspondence: [email protected] Plastic Surgery Division, Department of Surgery, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria
Melanin is a photo protective pigment, protecting the skin from the harmful effects of ultraviolet radiation. Its deficiency therefore predisposes to various degrees of actinic injury to the skin. These include sunburns, blisters, Centro facial lentiginosis, ephelides, solar elastosis, solar keratosis, basal cell carcinomas and squamous cell carcinomas [5,8]. Squamous cell carcinoma has been reported to be the commonest skin malignancy seen in albinos [9,10]. In Africa the incidence of squamous cell carcinoma in th
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