Primary cutaneous malignancies in black African patients with oculocutaneous albinism in KwaZulu-Natal Province, South Africa

Background. Individuals with oculocutaneous albinism (OCA) face a significantly heightened risk of developing skin cancer owing to increased sensitivity to ultraviolet (UV) radiation. Data on the epidemiology and geographical distribution of cutaneous malignancies among persons with albinism (PWA) in KwaZulu-Natal Province (KZN), South Africa, remain limited. Objective. To investigate the demographic and regional patterns of primary cutaneous malignancies within this high-risk population. Methods. We conducted a retrospective descriptive analysis of all PWA diagnosed with histologically confirmed primary cutaneous malignancies treated at a tertiary healthcare centre in KZN between January 2002 and June 2022. Sociodemographic, geographical and tumour characteristics were extracted from electronic medical records. Results. A total of 221 patients (56.6% female, 43.4% male) with a mean (standard deviation) age of 37.9 (12.5) years contributed 618 histologically confirmed malignant lesions. 132/221 patients (59.7%) presented before 40 years of age. Female patients presented slightly earlier (37.1 (12.9 years)) than males (39.0 (12.0 years)). Geographical clustering was observed in eThekwini (43.0%), uMkhanyakude (20.8%) and King Cetshwayo (11.8%) municipalities. Squamous cell carcinoma (SCC) (50.2%) and basal cell carcinoma (BCC) (49.7%) were nearly equally distributed across all the districts; one cutaneous melanoma was identified. Conclusions. In KZN, PWA tended to develop skin cancer at a younger age than the general population. Notably, the proportions of SCC and BCC were roughly equivalent – a finding that contrasts with historical data, which show a predominance of SCC. The high incidence of skin cancer in coastal and rural districts aligns with elevated ambient UV exposure, and highlights disparities in healthcare access within these regions. These findings highlight the urgent need for targeted screening programmes, improved photoprotection strategies and culturally sensitive education initiatives to reduce morbidity and mortality among this vulnerable population.