Primary Cutaneous Malignancies in Ethiopia: A Retrospective Study From a Tertiary Referral Center

Background: Skin cancer predominantly affects individuals with Fitzpatrick skin types (I–III) and has long been considered rare among Black populations, mainly due to underreporting and limited research. Currently, the genetic classification of skin types proposed by Helmy suggests that darker skin represents the ancestral human phenotype, characterized by strong melanin-mediated photoprotection, whereas lighter skin types evolved through genetic adaptations to lower ultraviolet exposure. Understanding these genetic and environmental factors is crucial for defining disease patterns in Black patients. This study aims to describe the epidemiological and clinicopathologic characteristics of primary cutaneous malignancies in Ethiopia. Methods: A retrospective review of histologically confirmed primary cutaneous malignancies was conducted at ALERT (All-African Leprosy Rehabilitation and Training Center) Hospital, Addis Ababa, from January 2016 to December 2018. Data on demographics, anatomical site, histological type, duration, and clinical stage were analyzed using descriptive statistics and χ 2 tests for categorical associations ( P < 0.05). Results: Among 310 cases, there was a slight male predominance (male:female = 1.25:1), and the mean age was 52 years (range, 7–90 y). The most frequent tumor was squamous cell carcinoma (54.2%), followed by basal cell carcinoma (17.7%). The lower limb was the most common site (50.3%), and 70% of patients presented with advanced disease (stages III–IV). Recurrent tumors comprised 7%, mainly dermatofibrosarcoma protuberans. Conclusions: Squamous cell carcinoma is the leading primary cutaneous malignancy, often presenting late and affecting the lower limbs. These findings highlight the need for early detection, public education, and improved access to care.