MELANOMA AND NON-MELANOMA SKIN CANCER IN ETHIOPIA

Padovese V., Terranova M., Morrone. A.

Dermatological care for all “A basic human right”
Addis Abeba, November 1-4, 2006

Introduction: 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. darkskinned 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 all 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 18 months’s medical activity (January 2005-July 2006) 14,510 patients have been examined in IDH and 18,118 skin diseases diagnosed. Most of the patients (61%) were in the age bracket of 16 to 35 years.
The records revealed 325 patients presented 356 skin tumours, which could be classified into 12 categories. Among these one quarter were malignant tumours (89) of the skin and the mucous membranes. We observed a substantial number of malignant tumours 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 population, 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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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