MELANOMA AND NON-MELANOMA SKIN CANCER IN ETHIOPIA

Morrone A., Terranova M., Padovese V.

21° WORLD CONGRESS OF DERMATOLOGY
Buenos Aires, September 30 – October 5 2007

Background
Skin cancer in dark-skinned African people is believed to be infrequent, but there are very little data available concerning the actual prevalence and incidence of non-melanoma skin cancer and melanoma in this population. Some authors reported an incidence of skin cancer in 2 % of people of African descent (i.e. dark-skinned people) worldwide.
Unlike among people of European descent, for whom basal cell carcinoma (BCC) is most common, squamous cell carcinoma (SCC) is the most frequent type of non-melanoma skin cancer among dark-skinned people, making up 60 % of al cases of skin neoplasm. Melanoma is considered very rare amongst dark-skinned people; the most common type is acral lentiginous.
Methods
On January 2005 a dermatological hospital named Italian Dermatological Hospital (IDH) has been opened in Quiha, a village near Mekele, the capital city of Tigray Region in Ethiopia. San Gallicano Institute and IISMAS (International Institute of Medical, Anthropological and Social Sciences) in collaboration with Tigray Regional Health Bureau and Mekele Civil Hospital have started the medical activity.
Results
During the first 24 month’s medical activity (February 2005-January 2007) 19,981 patients have been examined in IDH and 22,118 skin diseases diagnosed. Most of the patients (61 %) were in the age bracket of 16 to 35 years. The records revealed 375 patients presented 406 skin tumors, which could be classified into 12 categories.
Among these one quarter were malignant tumors of the skin and the mucous membranes. We observed a substantial number of malignant tumors related with sexually transmissible infections (condylomata) and chronic leg ulcers. Three SCC rising on chronic burn scar and five pigmented BCC. Although the high prevalence in the region of HIV infection Kaposi’s sarcoma has not yet been recorded in our hospital.
Discussion
All the patients affected by skin neoplasm were treated in our Hospital. In our opinion, the aforementioned figures are underestimated; much of this popula¬tion, particularly those living in Africa, does not have access to dermatological specialists, which may result in the under-diagnosis of melanoma and other skin cancer.
References
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2. Pitche P, Tchangai-Walla K., Skin cancers in black subjects, Ann Dermatol Venereol. 2006 Nov;133(11):932-5
3. Hu S, Ma F, Collado-Mesa F, Kirsner RS. UV radiation, latitude and melanoma in US Hispanics and blacks. Arch Dermatol 2004 Jul;140(7):819-24