Xeroderma pigmentosum in Ghanaians: a report of three cases and review of literature.

BACKGROUND

Xeroderma pigmentosum is an autosomal recessive disease with sun sensitivity, photophobia, early onset of freckling, and subsequent neoplastic changes on sun-exposed surfaces. There is cellular hypersensitivity to UV radiation and to certain chemicals in association with abnormal DNA repair. Patients with defective DNA nucleotide excision repair (NER) have defects in one of seven NER genes; xeroderma pigmentosum variants have normal NER and a defect in a polymerase gene.

STUDY

DESIGN

This is a case presentation of three patients with the features of xeroderma pigmentosum, aged 48, 15, and 14 years. The latter two patients were females. Each presented with areas of hyper-and hypo-pigmentation over sun exposed body surfaces. Each patient had a minimum of two cutaneous malignancies, distributed on the upper chest, face or scalp.

RESULTS

The first and third patients had their lesions surgically excised and the defects were skin grafted. The second patient was treated with radiotherapy. All the lesions presented were confirmed histologically as squamous cell carcinoma. No recurrence of the malignancies has been noticed.

CONCLUSION

Xeroderma pigmentosum is not rare in Ghana. Early recognition of the disease is necessary to avoid morbidity and mortality from malignant complications. The use of other treatment modalities such as sunscreens, oral retinoids, and chemical therapy with 5-fluorouracil is discussed.