Histopathologic patterns of cutaneous malignancies in individuals with oculocutaneous albinism in Anambra state, Nigeria: a paradigm swing?

BACKGROUND: A high proportion of skin cancers in Nigeria occur in Individuals with oculocutaneous albinism (OCA). A reduction or absence of melanin, a skin pigment with photoprotective properties, makes them susceptible to skin malignancies such as squamous cell carcinomas (SCCs), basal cell carcinomas (BCCs) and rarely melanomas. Globally, BCCs are the commonest cutaneous malignancies among Caucasians and in fair-skinned Africans. This has been attributed to the greater effect of melanin in protecting against UV damage in the basal layer of the epidermis. Older retrospective studies on African albinos suggested that SCCs accounted for a higher prevalence of skin cancers in albinos, followed by BCCs. Melanoma has been consistently documented to be rare in all of these reports. Recent reports however noted BCCs to occur at an increasing frequency, suggesting a higher frequency than previously documented. These conflicting reports reflect the need to re-explore the pattern of cutaneous malignancies in albinos in order to reconcile the role of pigmentation, UV exposure and the variance between the frequencies of the different keratinocyte skin cancers among extreme skin phenotypes. This study explores the pattern of cutaneous malignancies seen in albinos in South East Nigeria. OBJECTIVE: To determine the pattern of cutaneous malignancies among albinos in Anambra state, Nigeria. MATERIALS AND METHODS: A cross-sectional study conducted in Anambra State, Nigeria. Ninety albinos from the Albino foundation Anambra state were recruited. Malignant dermatoses were characterized clinically and confirmed by histology. Fifty-eight lesions from 30 albinos were biopsied to determine the presence of malignancy. RESULTS: Skin cancers were seen in 20.98% of all participants and in 18 (60%) of all the albinos who had skin biopsy. The SCC/BCC ratio was 1.0: 2.3. There was no cutaneous melanoma. CONCLUSION: Contrary to previous reports, it would appear that the pattern of cutaneous malignancies in albinos shows the same trend as that seen in Caucasians and fair-skinned Africans.

Diversity of human lip prints: a collaborative study of ethnically distinct world populations.

BACKGROUND: Cheiloscopy is a comparatively recent counterpart to the long established dactyloscopic studies. Ethnic variability of these lip groove patterns has not yet been explored. AIM: This study was a collaborative effort aimed at establishing cheiloscopic variations amongst modern human populations from four geographically and culturally far removed nations: India, Saudi Arabia, Spain and Nigeria. SUBJECTS AND METHODS: Lip prints from a total of 754 subjects were collected and each was divided into four equal quadrants. The patterns were classified into six regular types (A-F), while some patterns which could not be fitted into the regular ones were segregated into G groups (G-0, G-1, G-2). Furthermore, co-dominance of more than one pattern type in a single quadrant forced us to identify the combination (COM, G-COM) patterns. RESULTS AND CONCLUSION: The remarkable feature noted after compilation of the data included pattern C (a bifurcate/branched prototype extending the entire height of the lip) being a frequent feature of the lips of all the populations studied, save for the Nigerian population in which it was completely absent and which showed a tendency for pattern A (a vertical linear groove) and a significantly higher susceptibility for combination (COM) patterns. Chi-square test and correspondence analysis applied to the frequency of patterns appearing in the defined topographical areas indicated a significant variation for the populations studied.

Prevalence of Linea nigra in patients with benign prostatic hyperplasia and prostate carcinoma.

BACKGROUND: Linea nigra (LN) is linear hyperpigmentation occurring from the umbilicus to the pubic symphysis. Although commonly associated with pregnancy (when it is known as linea gravidarum), it has been found in normal male and female individuals, particularly in the younger age group where estrogen or lack of sensitivity of androgen receptors has been suggested as a possible factor. From a previous study the incidence of LN varied in different genders, age groups, and certain clinical status such as pregnancy and, in men, benign prostate hyperplasia (BPH)/prostate carcinoma (PC). OBJECTIVE: The need to get a clinical feature that can aid diagnosis of PC, the commonest male neoplasm in Nigeria, at an affordable cost prompted us to look at the incidence of LN in three male populations (i.e., one with BPH, one with PC, and a control population unaffected by these two conditions). Gynecomastia and female hair distribution, two features considered hormone related were looked for additionally in the study population. The study was carried out in a teaching hospital in Ibadan, southwestern Nigeria. RESULTS: LN was found in 48% of PC, 26% of BPH, and 8% of controls. Female pubic hair was found in 48% of PC, 26% of BPH, and 12% of controls. Gynecomastia was found in 36% of PC, 12% of BPH, and 0% of controls. Differences between patients with BPH, PC, and controls regarding incidence of LN and female pubic hair were deemed explicable by chance (P = 0.17, Fisher exact test). Differences between PC and BPH patients with respect to gynecomastia were deemed inexplicable by chance (P = 0.008, Fisher exact test). CONCLUSION: LN alone cannot be used to differentiate PC and BPH. Further studies will be needed to characterize the role of LN in these conditions in men before and after treatment.

The incidence of lower mid-trunk hyperpigmentation (linea nigra) is affected by sex hormone levels.

The incidence of linea nigra was studied in 1,550 Nigerians of both sexes and of different age groups and among pregnant women and men with benign and malignant prostatic diseases over a nine-month period. From the study, it would appear that linea nigra increases in incidence from the age group 0-15 years (31.4%) to the age group 16-30 years (47.3%) before starting to fall in clinically normal individuals >30 years to 19.2%. For age groups 0-5 years, 6-10 years and 16-30 years, females more often than males have a linea nigra. For age group 11-15, males are equally as likely as females to have a linea nigra. The results suggest that women over 30 are more likely to have a linea nigra than men, but there are too few patients to make a definite statement, given the number of statistical tests performed. Pregnant women far more often have a linea nigra than nonpregnant women of the same age. The findings suggest that the likelihood of having a linea nigra depends on the level of sex hormones. This means that changes in the levels of hormones, either due to disease or drugs, may be reflected in changes in the incidence of a linea nigra. If this finding is confirmed, the linea nigra may serve as a convenient, noninvasive, free marker of alterations in sex hormones.