Vitiligo-like Depigmentation Associated with Metastatic Melanoma of an Unknown Origin

Cho, Eun Ah; Lee, Myung Ah; Kang, Hoon; Lee, Seung Dong; Kim, Hyung Ok; Park, Young Min

doi:10.5021/ad.2009.21.2.178

Cited by 12 publications

(6 citation statements)

References 16 publications

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“…All those theories can explain the correlation between melanoma and vitiligo. The evidence supports that the presence of vitiligo may be a favorable prognostic factor for survival theoretically due to the immune mechanism responsible for melanocytic proliferation causing depigmentation of skin and spontaneous regression of primary melanoma which were reported [ 26 – 28 ]. One of the studies reported by Nordlund et al [ 28 ] showed that a 10-year survival rate among patients with nonmetastatic melanoma with vitiligo was 49%.…”

Section: Discussionsupporting

confidence: 82%

Metastatic Melanoma of Uncertain Primary with 5-Year Durable Response after Conventional Therapy: A Case Report with Literature Review

Chantharasamee

Treetipsatit

2018

Case Reports in Oncological Medicine

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A 51-year-old Thai woman presented with bilateral leg edema and painful left inguinal mass for 6 months. Physical examination revealed matted bilateral inguinal lymph nodes up to 9 cm in size. Otherwise, physical examinations including skin were unremarkable. The result of the lymph node incisional biopsy is consistent with that of metastatic melanoma. The extensive investigation demonstrated multiple intra-abdominal and inguinal lymph nodes without detectable primary tumor. Palliative radiation and conventional chemotherapy were prescribed. The CT scan between treatments showed that the response was stable disease, but the following CT scan demonstrated a gradual decrease in size from August 2012 to November 2017 including the lesions outside radiation fields. Moreover, she developed vitiligo during a follow-up visit. The previous data reported the median overall survival among the patients who were treated with conventional chemotherapy ranging from 9.1 to 9.3 months and whose 5-year survival was less than 10%. This case represented a metastatic melanoma of unknown primary who achieved a durable response by conventional treatment. The clinical features including nodal-only disease, vitiligo, and abscopal effect of radiation were considered to be the favorable factors.

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Section: Discussionsupporting

confidence: 82%

Metastatic Melanoma of Uncertain Primary with 5-Year Durable Response after Conventional Therapy: A Case Report with Literature Review

Chantharasamee

Treetipsatit

2018

Case Reports in Oncological Medicine

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“…The development of leukoderma post treatment with IL-2 for melanoma has been previously reported (1)(2)(3)(4)(5). However the occurrence of leukoderma in association with newer immunomodulating drugs, such as vemurafenib and ipilimumab, has just recently been reported (6,7).…”

Section: Discussionmentioning

confidence: 95%

“…One of the known side-effects of immunotherapeutic agents for melanoma, such as interleukin-2 (IL-2), vemurafenib, and ipilimumab, is leukoderma; however leukoderma has also been associated with higher rates of metastatic melanoma, as well as preceding the detection of melanoma (1)(2)(3)(4)(5). Collectively, this phenomenon is called melanoma-associated leukoderma (MAL).…”

mentioning

confidence: 97%

Immunotherapy-induced Leukoderma from Treatment of Melanoma with IL-2: A Case Report and a Review of the Literature

Gathings¹,

Lewallen²,

Yosipovitch³

2015

Acta Derm Venerol

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Melanoma-associated leukoderma (MAL) is a relatively uncommon phenomenon in the literature that can present (1) before melanoma detection, (2) after detection and before treatment, and (3) after treatment with immunotherapeutic agents. We report a case of MAL in an 83-year-old man after treatment with high dose IL-2 for metastatic melanoma and further describe the literature of the underlying mechanisms behind it that involve the immune system. Cytotoxic CD8+ T cells are thought the mediate the process at a cellular level. Self-antigens (e.g. MART-1/2, gp100, tyrosinase) have been presented on the surface of both normal and malignant melanocytes and mediate the development of MAL after cytotoxic CD8+ T cells attack both cell types. Autoimmune manifestations have a positive effect on tumor immunity, with patients at stage III and stage IV melanoma showing a better prognosis after leukoderma development. In addition, immunotherapy induced leukoderma has been associated with a higher therapeutic response rate. Recently, newer immuno-therapeutic drugs, such as vemurafenib and ipilimumab, have been associated with leukoderma as a side effect.

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“…Similar vitiligo-like depigmentation in malignant melanoma has been reported in literature. [ 8 9 ] It is postulated that depigmentation is due to immune-mediated response against antigens shared by normal melanocytes and melanoma cells by CD8+ T cells, thus resulting in destruction of normal melanocytes. [ 10 ] Our case was unique in having icthyotic scaling in addition to leukoderma-like lesions which is not reported in literature.…”

Section: Discussionmentioning

confidence: 99%

Unusual Morphological Presentation of Cutaneous Malignant Melanoma

Dash

Pradhan

Ss³

2021

Indian Dermatology Online Journal

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Cutaneous malignant melanoma is a rapidly progressing skin tumor accounting for most deaths from skin malignancies. Four morphological variants (nodular, superficial spreading, lentigo maligna, and acral lentiginous) are described in the literature. Here we are reporting malignant melanoma in a 35-year-old male who presented with depigmented plaques with few hyperpigmented areas and extensive overlying scaling. The patient progressed to the nodular stage within 2 weeks and succumbed to death during chemotherapy. We are reporting such rare presentation of malignant melanoma to create awareness among dermatologists to avoid misdiagnosis and delayed treatment which can lead to rapid progression and fatal outcome.

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Vitiligo-like Depigmentation Associated with Metastatic Melanoma of an Unknown Origin

Cited by 12 publications

References 16 publications

Metastatic Melanoma of Uncertain Primary with 5-Year Durable Response after Conventional Therapy: A Case Report with Literature Review

Metastatic Melanoma of Uncertain Primary with 5-Year Durable Response after Conventional Therapy: A Case Report with Literature Review

Immunotherapy-induced Leukoderma from Treatment of Melanoma with IL-2: A Case Report and a Review of the Literature

Unusual Morphological Presentation of Cutaneous Malignant Melanoma

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