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      A Histopathological Study of Skin Lesions in Individuals with Oculocutaneous Albinism in Togo in 2019

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          Abstract

          Objective

          The aim of this study was to study the histopathological patterns of skin lesions in persons with albinism (PWA) in Togo in 2019.

          Method

          During two mobile skin care clinics in 2019, biopsies/excisional biopsies were performed in PWA in case of clinical doubt or in front of lesions suspected to be cancerous for histological examination. Anatomopathological reports were thus analysed.

          Results

          During the two mobile skin care clinics, 115 biopsies/excisional biopsies were carried out in 79 PWA, with a mean age of 24 ± 16.1 years. Histological examination led to a diagnosis in 110 cases (95.6%) and was inconclusive in 5 cases (4 cases of uncertain histological diagnosis and one case of nonspecific histological lesions). Fourteen different histological diagnoses were made, with a frequency ranging from 0.9% (one case) to 26.9% (31 cases). The four most frequent diagnoses in descending order were basal cell carcinomas (BCCs) (31 cases; 26.9%), invasive squamous cell carcinomas (SCCs) or Bowen's disease (23 cases; 20%), keratosis (20 cases; 17.3%), and cysts (seven cases; 6.1%). The 54 skin carcinomas were diagnosed in 33 (41.8%) of the 79 patients who underwent skin biopsies/excisional biopsies. The BCC/SCC ratio was 1.3. No cases of cutaneous melanoma had been diagnosed.

          Conclusion

          Skin cancers represent the main histological diagnosis in PWA (46.9%) in Togo in 2019. The pattern of cutaneous malignancies in PWA shows the same trend as that seen in Caucasians with a predominance of basal cell carcinomas.

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          Most cited references19

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          Albinism in Africa as a public health issue

          Background Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition and OCA2, tyrosine-positive albinism, is the most prevalent type found throughout Africa. Due to the lack of melanin, people with albinism are more susceptible to the harmful effects of ultraviolet radiation exposure. This population must deal with issues such as photophobia, decreased visual acuity, extreme sun sensitivity and skin cancer. People with albinism also face social discrimination as a result of their difference in appearance. The World Health Organization is currently investigating the issues concerning this vulnerable population. Methods Systematic electronic search of articles in PubMed concerning albinism in Africa. Furthermore, a World Health Organization (WHO) pilot survey of albinism was drafted in English, French and Portuguese, and distributed to African countries through WHO African Regional Offices (AFRO) in an attempt to gather further information on albinism. Results Epidemiologic data on albinism, such as prevalence, were available for South Africa, Zimbabwe, Tanzania and Nigeria. Prevalences as high as 1 in 1,000 were reported for selected populations in Zimbabwe and other specific ethnic groups in Southern Africa. An overall estimate of albinism prevalences ranges from 1/5,000 – 1/15,000. In addition, both the literature review and the survey underscored the medical and social issues facing people with albinism. Conclusion The estimated prevalence of albinism suggests the existence of tens of thousands of people living with albinism in Africa. This finding reiterates the need for increased awareness of and public health interventions for albinism in order to better address the medical, psychological and social needs of this vulnerable population.
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            Albinism and skin cancer in Southern Africa.

            The presence of skin cancer was investigated in 111 albinos belonging to the black (Negro) population of Johannesburg, South Africa. The overall rate was 23.4%, the risk increasing with age. Identifiable risk factors included: environmental exposure to ultraviolet radiation; inability to produce ephelides ('freckles'); and possibly ethnicity. The head was the site most commonly affected, and squamous was far more common than basal cell carcinoma. No melanomas were detected. Recommendations are made regarding prevention of skin cancer in the at-risk group.
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              Actinic damage and skin cancer in albinos in northern Tanzania: findings in 164 patients enrolled in an outreach skin care program.

              Persons with albinism are particularly vulnerable to the deleterious effects of UV light on their skin. We obtained histories and performed skin examinations on 164 albino patients living in equatorial Africa to determine their sun exposure, sun protection, and sun damage. Many patients did not wear hats and most wore short-sleeved shirts. Except for four infants, all patients had sunburned skin. Actinic cheilitis, actinic keratoses, and skin cancers were detected in many patients. Sun protection methods will be important for prevention of skin damage in albino patients.
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                Author and article information

                Contributors
                Journal
                J Skin Cancer
                J Skin Cancer
                JSC
                Journal of Skin Cancer
                Hindawi
                2090-2905
                2090-2913
                2020
                29 July 2020
                : 2020
                : 2361957
                Affiliations
                1Service de Dermatologie et IST, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
                2Service de Dermatologie et IST, CHU Campus Université de Lomé, Lomé, Togo
                3Centre National de Dermatologie de Gbossimé, Lome, Togo
                4Unité D'histopathologie, Clinique Mélia, Lomé, Togo
                5Service de Chirurgie Maxillo-Faciale et Plastique, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
                6Service de Dermatologie et IST, CHU Kara, Université de Kara, Kara, Togo
                7Service de Dermatologie et IST, Centre Hospitalier Régional de Tomdè, Kara, Togo
                8Laboratoire D'anatomie et Cytotologie Pathologique, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
                Author notes

                Academic Editor: Silvia Moretti

                Author information
                https://orcid.org/0000-0002-8889-2693
                https://orcid.org/0000-0003-2619-8396
                https://orcid.org/0000-0002-5844-0856
                https://orcid.org/0000-0002-6932-3540
                Article
                10.1155/2020/2361957
                7411479
                cd79660b-ecaa-429f-8873-9b3576693bfc
                Copyright © 2020 Bayaki Saka et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 6 May 2020
                : 9 July 2020
                Categories
                Research Article

                Oncology & Radiotherapy
                Oncology & Radiotherapy

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