Primary cutaneous malignancies in nonalbino and albino Africans

The pigmented skin of black Africans has been credited with reduction in risk of skin cancer. African albinos have inherited defects in skin melanin deposition, which predisposes them to ultraviolet radiation-induced cutaneous carcinogenesis. We compared the manifestation of skin cancers between albino and nonalbino Africans aiming to describe the effect of pigmentation or lack of it on the epidemiological characteristics of skin cancer in Africans.

Cutaneous malignancies seen in our institution over a 19-year period were analyzed using SPSS statistical software. Results were presented in tables of frequencies. Continuous variables were presented as mean with standard deviation and compared with independent sample t-test and ANOVA. Alpha level of <0.05 was considered significant.

There were 86 albinos and 364 nonalbinos in the study. Mean age (SD) at presentation for albinos was 41 (14) years and for nonalbinos 52 (17) years. Albinos had most tumors in the head and neck region and upper extremities. For nonalbinos, lower extremities followed by anogenital region were the most common body site of cutaneous malignancy. Squamous cell carcinoma was the most common type of skin cancer in the albino and nonalbino patients. No case of malignant melanoma was diagnosed in the albino group.

Albino skin cancer patients were much younger than nonalbinos. Albinos and nonalbinos differ in body site distribution of skin cancers. Distribution of keratinocyte carcinomas in albinos parallels the reported findings in Caucasians. Albinos may have some level of protection from cutaneous melanoma in spite of hypomelanized skin.