Vitiligo-like lesions, although rare, are believed to be a prognostic factor in malignant melanoma. While a predictive role for such lesions was shown with immunomodulatory therapies, this relation was not demonstrated with temozolomide. We present 3 patients with metastatic malignant melanoma who developed vitiligo-like skin lesions accompanying good response to treatment and prolonged survival. Onset of vitiligo-like lesions with temozolomide in metastatic malignant melanoma may predict long-term response for this treatment.
OngenaeK.Van GeelN.NaeyaertJ.M.Evidence for an autoimmune pathogenesis of vitiligo. Pigment Cell Res.2003; 16(2): 90–100.
2.
LuitenR.M.KueterE.W.MooiW.Immunogenicity, including vitiligo, and feasibility of vaccination with autologous GM-CSF-transduced tumor cells in metastatic melanoma patients. J Clin Oncol.2005; 23(35): 8978–8991.
3.
GuillotB.BlazquezL.BessisD.DereureO.GuilhouJ.J.A prospective study of cutaneous adverse events induced by low-dose alpha-interferon treatment for malignant melanoma. Dermatology.2004; 208(1): 49–54.
4.
PhanG.Q.AttiaP.SteinbergS.M.WhiteD.E.RosenbergS.A.Factors associated with response to high-dose interleukin-2 in patients with metastatic melanoma. J Clin Oncol.2001; 19(15): 3477–3482.
5.
GogasH.loannovichJ.DafniU.Prognostic significance of autoimmunity during treatment of melanoma with interferon. N Engl J Med.2006; 354(7): 709–718.
6.
BystrynJ.C.RigelD.FriedmanR.J.KopfA.Prognostic significance of hypopigmentation in malignant melanoma. Arch Dermatol.1987; 123(8): 1053–1055.
7.
BoasbergP.D.HoonD.S.PiroL.D.Enhanced survival associated with vitiligo expression during maintenance biotherapy for metastatic melanoma. J Invest Dermatol.2006; 126(12): 2658–2663.
8.
TaïebA.PicardoM.; VETF Members. The definition and assessment of vitiligo: a consensus report of the Vitiligo European Task Force. Pigment Cell Res.2007; 20(1): 27–35.
9.
Wankowicz-KalinskaA.Le PooleC.van den WijngaardR.StorkusW.J.DasP.K.Melanocyte-specific immune response in melanoma and vitiligo: two faces of the same coin?Pigment Cell Res.2003; 16(3): 254–260.
10.
TaïebA.PicardoM.Clinical practice. Vitiligo. N Engl J Med.2009; 360(2): 160–169.
11.
SchallreuterK.U.LevenigC.BergerJ.Vitiligo and cutaneous melanoma. A case study. Dermatologica.1991; 183(4): 239–245.
12.
LengagneR.Le GalF.A.GarcetteM.Spontaneous vitiligo in an animal model for human melanoma: role of tumor-specific CD8+ T cells. Cancer Res.2004; 64(4): 1496–1501.
13.
GarbelliS.MantovaniS.PalermoB.GiachinoC.Melanocyte-specific, cytotoxic T cell responses in vitiligo: the effective variant of melanoma immunity?Pigment Cell Res.2005; 18(4): 234–242.
14.
KempE.H.WatermanE.A.WeetmanA.P.Autoimmune aspects of vitiligo. Autoimmunity.2001; 34(1): 65–77.
15.
CunhaD.PachecoF.A.CardosoJ.Vitiligo: a good prognostic factor in melanoma?Dermatol Online J.2009; 15(2): 15.
16.
QuaglinoP.MarencoF.Osella-AbateS.Vitiligo is an independent favourable prognostic factor in stage III and IV metastatic melanoma patients: results from a single-institution hospital-based observational cohort study. Ann Oncol.2010; 21(2): 409–414.
17.
NordlundJ.J.KirkwoodJ.M.ForgetB.M.MiltonG.AlbertD.M.LernerA.B.Vitiligo in patients with metastatic melanoma: a good prognostic sign. J Am Acad Dermatol.1983; 9(5): 689–696.
18.
RosenbergS.A.WhiteD.E.Vitiligo in patients with melanoma: normal tissue antigens can be targets for cancer immunotherapy. J Immunother Emphasis Tumor Immunol.1996; 19(1): 81–84.
