Original Article http://mjiri.iums.ac.ir Medical Journal of the Islamic Republic of Iran (MJIRI) [ DOI: 10.18869/mjiri.31.3 ] Med J Islam Repub Iran. 2017(12 Jan);31.3. https://doi.org/10.18869/mjiri.31.3 Common malignant cutaneous conditions among albinos in Kenya Seyed Emad Emadi1, Andrew Juma Suleh2, Farhang Babamahmoodi3, Fatemeh Ahangarkani4, Vanessa Betty Chelimo2, Beatrice Mutai2, Seyyed Reza Raeeskarami5, Alireza Ghanadan6, Seyed Naser Emadi7* Received: 18 June 2016 Published: 11 Jan 2017 Downloaded from mjiri.iums.ac.ir at 14:18 IRDT on Thursday May 18th 2017 Abstract Background: Albinos in Africa are at constant risk of developing skin cancer due to the damage caused by ultra-violet exposure. This study identifies the common skin conditions among albinos in Kenya as a country located along the equator. Methods: In this descriptive study on albino patients who were admitted to Mbagathi District Hospital in Nairobi, Kenya the census method was used for sampling and a total of 151 albinos were registered. All necessary data including age, gender, type, site and the number of skin lesions were recorded. Suspected patients with malignant and premalignant lesions were studied individually through skin biopsy and histopathological investigation. Finally, the collected data were analyzed using SPSS software. Results: Albinos with serious skin lesions were 121(80%) patients. Females were 64 (52.9%). The frequency of the following premalignant and malignant skin lesions including actinic-cheilitis, solar elastosis, actinic keratosis (AK), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) were 17.88%, 11.92%, 37.08%, 7.94% and 5.29%, respectively. Hands (20.52%), face (19.20%), head (18.18%), shoulder (14.56%) and neck (7.94%) were the most affected areas by malignant and premalignant lesions. Conclusions: BCC was the most common type of cutaneous malignancy on the face and shoulders while AK was the most common cutaneous pre-malignancy on the hands and face in albinos in Kenya. Therefore, appropriate physical protection, avoiding any trauma when carrying sharp, heavy or rough instruments by the shoulder and hands, and finally urgent and quality treatment for any lesion even a small erosion and ulcer, especially on exposed areas in albinos, are recommended. Keywords: Albinos, Skin Cancer, Kenya Copyright© Iran University of Medical Sciences Cite this article as: Emadi SE, Juma Suleh A, Babamahmoodi F, Ahangarkani F, Betty Chelimo V, Mutai B, Raeeskarami SR, et al. Common malignant cutaneous conditions among albinos in Kenya. Med J Islam Repub Iran. 2017(12 Jan);31:3. https://doi.org/10.18869/mjiri.31.3 Introduction Albinism is an inherited disorder characterized by the complete or partial absence of pigment melanin in the skin, hair and eyes due to absence or defect of tyrosinase, an enzyme involved in the production of melanin (1,2). Albinism has a worldwide distribution; it affects only 1 in 20,000 people. In Africa, incidences ranging from 1 in 2,700 to 1 in 10,000 have been reported in different studies (3,4). Melanin as a photo protective pigment protects the skin from the effects of ultraviolet radiation (3). Persons with albinism and other skin diseases such as vitiligo, _______________________________ Corresponding author: Dr Seyed Naser Emadi, firstname.lastname@example.org 1. Mazandaran University of Medical Sciences, Sari, & Iranian Red Crescent Society, Tehran, Iran 2. Mbagathi District Hospital, University of Nairobi, Nairobi, Kenya 3. Antimicrobial resistance research center, Mazandaran University of Medical Sciences, Sari, Iran 4. Antimicrobial Resistance Research Center, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran 5. Department of Pediatric, Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran & Iranian Red Crescent Society, Tehran, Iran 6. Department of Dermatopathology, Razi hospital, Tehran University of Medical Sciences, Tehran, Iran 7. Skin Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran & Iranian Red Crescent Society, Tehran, Iran psoriasis, lichen planus and Darier diseases are at constant risk of developing skin cancer due to the damage caused by ultra-violet exposure and, African albinos are at more risk of developing skin cancers given their location along the equator (5-7). The lack of melanin in African albinos increases the risk of developing skin cancer by 1,000 fold as compared with the general African population (8,9). The three most common forms of skin cancer are BCC, SCC and melanoma. Skin cancer usually occurs on the scalp, ears, back of the hands, or the lower lip. ↑What is “already known” in this topic: In Africa, albinism incidence ranges from 1 in 2,700 to 1 in 10,000 in different regions. Kenyan albinos who live on the equator line are at constant risk of developing skin cancer due to the damage caused by ultra-violet exposure. →What this article adds: Actinic keratosis still remains as the predominant skin condition found among Kenyan people living with albinism. Concerning the skin cancer, sensitization and informing the albino patients, especially outdoor workers, might decline the number of patients with AK, SCC, and BCC.