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Vitiligo and Melanoma-Associated Vitiligo: Understanding Their Similarities and Differences

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Abstract

Background

There has been a significant increase in the number and efficacy of therapies for advanced melanoma. Immunotherapies, such as anti-cytotoxic T-lymphocyte antigen-4 and programmed cell death-1 inhibitors, have improved the prognosis for patients with advanced melanoma. While spontaneous melanoma-associated vitiligo is a known phenomenon, the occurrence of melanoma-associated vitiligo following melanoma therapy is now recognized to associate with favorable outcomes.

Objective

The objective of this article is to provide a comprehensive literature review of melanoma-associated vitiligo and explore the insights these findings provide about the pathobiology of vitiligo and mechanisms underlying melanoma therapies.

Methods

PubMed and Science Direct databases were searched for studies pertaining to melanoma-associated vitiligo. The 36 studies reviewed included meta-analyses (n = 2), prospective cohort studies (n = 4), prospective observational studies (n = 3), retrospective studies (n = 12), case series (n = 2), and case reports (n = 13).

Results

The basic mechanisms underlying melanoma-associated vitiligo and vitiligo may be shared. Characterization of these mechanisms will identify new biomarkers and therapeutic targets for both melanoma and vitiligo.

Conclusions

Co-opting the immune system to target tumor antigens highlights the potential overlap between anti-tumor immunity and autoimmunity. The development of vitiligo-like depigmentation in association with immunotherapy for melanoma may provide insights into both the immune response against melanoma as well as the pathogenesis of vitiligo.

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Authors and Affiliations

  1. Department of Dermatology, Keck School of Medicine, University of Southern California, 830 South Flower Street, Suite 100, Los Angeles, CA, 90017, USA

    Brandon E. Cohen & Nada Elbuluk

  2. Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA

    Prashiela Manga & Krysta Lin

Authors
  1. Brandon E. Cohen
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  2. Prashiela Manga
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  3. Krysta Lin
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  4. Nada Elbuluk
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Corresponding author

Correspondence to Nada Elbuluk.

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Funding

This study was in part funded by the Leo Foundation (Grant number LF16101).

Conflict of interest

Brandon E. Cohen, Prashiela Manga, Krysta Lin, and Nada Elbuluk have no conflicts of interest that might be directly relevant to the content of this article.

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Cohen, B.E., Manga, P., Lin, K. et al. Vitiligo and Melanoma-Associated Vitiligo: Understanding Their Similarities and Differences. Am J Clin Dermatol 21, 669–680 (2020). https://doi.org/10.1007/s40257-020-00524-0

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