A descriptive retrospective study of non-melanoma skin cancers in African patients with albinism at Chris Hani Baragwanath Academic Hospital. July 2015 – June 2017
Date
2020
Authors
Buthelezi, S'lindile Omega
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Abstract
Background
Oculocutaneous albinism (OCA) is an autosomal recessive genetic disorder characterised by
reduced or absent melanin pigment in the skin, eyes and hair. The most serious sequelae are
gross visual disturbances and development of skin cancers. Albinism patients develop pre
malignant and malignant lesions at an earlier age compared to normal population. Albinos
living closer to the equator are at a higher risk of non-melanoma skin cancers.
The skin is the largest organ in the human body. It is therefore the commonest site for
cancers. The majority of skin cancers are non-melanoma skin cancers, namely basal cell
carcinomas (BCC) and squamous cell carcinomas (SCC). They account for 20-30% of
neoplasms seen in Caucasians and 1-2% in coloured skin. Chronic sun exposure is the major
contributing factor to developing these skin cancers. (Kennedy et al, 2003). Unfortunately the exact prevalence of non-melanoma skin cancers in the South African
albinism population is not known. Limited studies have been done in Africa which described
the prevalence of skin lesions and skin cancers affecting the albinism population.
Objectives
Todetermine the number of patients with basal cell carcinomas, squamous cell carcinomas
and other non-melanoma skin cancers in both sexes, different age groups, tumour sites in
patients with albinism attending Chris Hani Baragwanath Academic Hospital.Methods
This study is a retrospective study of laboratory reports of histologically confirmed skin cancers
of patients attending Chris Hani Baragwanath Academic Hospital, whose skin biopsy
specimens were submitted to the National Health Laboratory Service at Chris Hani
Baragwanath Academic Hospital from July 2013 to June 2017. The histology reports provided
demographic data and whether the patient has albinism or other risk factors for skin cancers.
The report also provided a description of the clinical lesions and site of the lesion. The report
also provides a histologic subtype of the skin cancer. Results
A total of 50 patients with albinism with confirmed NMSCs on histopathology reports were
studied. The study showed a female predominance with 60% patients being female and 40%
male. The youngest patient was 19 years old and the oldest was 81 years old. The mean age
was 45.44 year and the median age was 43 years from the sample of 50 patients. Out of the 50
patients, 32 patients had Basal cell carcinomas (64%), 26 patients had Squamous cell
carcinomas (52%) and 2 patients had Bowens disease (4%). The commonest site was the head
and neck region for all types of skin cancers. Conclusion
The prevalence of skin cancers in albinism patients is overwhelmingly high. Basal cell
carcinomas are predominant over squamous cell carcinomas. Unfortunately there is not enough
studies to describe the exact prevalence in South Africa. The last study done in Johannesburg
was in 1989. There is still a need to raise awareness and educate African patients on sun
protection and sun avoidance as well as early diagnosis and aggressive management of pre
malignant lesions.
Description
A research report submitted in
partial fulfilment for the requirements of the degree of Master of Dermatology to the Faculty of Health Sciences, University of The Witwatersrand, Johannesburg, 2020