Vitiligo and Cutaneous Melanoma

Abstract

The examination of 623 melanoma patients in North Germany yielded the depigmentation disorder vitiligo in 23 cases (i.e. 3.7%). In 11 patients, the disease preceded their tumor, whereas in 11 patients, vitiligo developed after diagnosis of primary and/or metastatic melanoma into the regional lymph nodes. In 1 case the onset of melanoma in relation to the tumor remained undefined. The prevalence of vitiligo increased with tumor risk factors based on tumor thickness and anatomical site of tumor location (i.e. for low risk 1.75% intermediate risk 5.2% and high risk 5.8%). A comparison of the prevalence of vitiligo to the normal population of Northwestern Europe (i. e. 0.38–0.57%) showed a 7- to 10-fold increase for the patients with melanoma. A reverse analysis of the data yielded a 180-fold higher prevalence of melanoma in the group of patients with vitiligo. These results strongly support a more thorough examination of patients with vitiligo for primary melanoma.

Vitiligo: Where Do We Stand?

“…A recent analysis in northwestern Europe suggests a 180-fold higher prevalence of melanoma in vitiligo patients, giving strong support to this hypothesis (Schallreuter et al, 1991b). Unfortunately, vitiligo and melanoma-associated leukoderma were considered as the same disorder and this remains to be demonstrated.…”

Vitiligo – Exogenous Factors

“…Following this treatment, vitiligo and abnormal thyroid function tests developed, and these were associated with the response. The presence of vitiligo was reported in patients with metastatic melanoma without any treatment and has been found to be a good prognostic indicator in some patients [26][27][28] . Since some melanoma-associated antigens have been found in normal melanocytes, the incidence of vitiligo suggests that the cellular mechanisms responsible for IL-2 response (activated T lymphocytes) can potentially cross-react with normal tissue.…”

Hypopigmentation Associated With an Adenovirus-Mediated gp100/MART-1–Transduced Dendritic Cell Vaccine for Metastatic Melanoma

“…20 Although these vaccine and immunotherapy trials support a close association between favorable outcome, we did not observe this relationship. Moreover, since patients with vitiligo can develop cutaneous melanomas, 12 the autoimmune aggression seen in vitiligo must be distinct from potent antitumor immunity.…”