皮肤病学和皮肤病杂志

Vitiligo, Melanoma Associated Hypopigmentation and Melanoma Incidence and Prognosis: Is There An Association?

Abstract

Soura E and Katsambas A

Malignant melanoma is considered as the most lethal of all skin cancers. However, it is also one of the most immunogenic, characterized by specific antigen presentation and dense lymphocytic infiltration. Many studies concerning melanoma have reported the concurrent presence of vitiligo or Melanoma Associated Hypopigmentation (MAH). This type of vitiligo can appear before or after MM diagnosis, or in tandem with treatment with immunotherapeutic drugs and has been associated with an improved prognosis and/or better response to immunotherapy treatments. This may be attributed to the fact that activated T cells against antigens found on malignant melanocytes can also recognize normal melanocytes and destroy them. On the other side, very limited data exist on whether classic vitiligo can offer protection against or is associated with a decreased incidence of MM. However, MAH represents an example of a strong link between tumor immunity and autoimmune responses. This unique characteristic may be of use as a biomarker in melanoma patients, allowing prediction of MM prognosis or response to specific treatment regimens. Up to this point only a few studies report patient data regarding classic vitiligo and MM. In this paper, the autoimmune hypothesis in the pathogenesis of vitiligo and MAH are discussed, focusing on similarities, differences and known autoantigens. In addition, the results of studies regarding MM and vitiligo or MAH are also summarized.