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Melanoma, nonmelanoma risk lower among vitiligo patients

Patients with vitiligo had a decreased risk for melanoma and nonmelanoma skin cancer, according to study results.

In a retrospective mail-in survey, researchers in the Netherlands compared 1,307 patients with vitiligo (median age, 61 years; 62.6% women) and 788 of the patients’ partners who did not have vitiligo (median age, 60 years; 43.7% women). Mean age of vitiligo onset was 37 years, and Fitzpatrick skin types 2 and 3 were most common among both cohorts. Associations between vitiligo and lifetime prevalence for melanoma and nonmelanoma skin cancer (NMSC) were measured by multivariate logistic regression models.

 

J.P.W. van der Veen

“From melanoma research, we know that a melanocyte-directed autoimmune response causing vitiligo-like ‘melanoma-associated leukoderma,’ is linked to a better prognosis in patients with widespread melanoma,” researcher J.P.W. van der Veen, MD, PhD, dermatologist at the Academic Medical Center, University of Amsterdam, told Healio.com. “We hypothesized that the autoimmune response against melanocytic antigens causing vitiligo protects against melanoma. This might indeed be one of the reasons for the decreased risk of melanoma we found in vitiligo patients.”

Patients with vitiligo were associated with a threefold lower probability of developing melanoma (adjusted OR=0.32; 95% CI, 0.12-0.88) and NMSC (aOR=0.28; 95% CI, 0.16-0.50) when adjusted for risk factors.

Seven patients with vitiligo had been diagnosed with melanoma, all occurring in nonvitiligo skin (two in situ, one superficial spreading type, four unspecified). Twelve nonvitiligo controls had 14 melanoma diagnoses (three in situ; six superficial spreading, one nodular and four unspecified).

Thirty patients with vitiligo were diagnosed with 37 basal cell carcinomas (BCCs; 15 nodular, seven micronodular, five superficial and 10 unspecified). Five vitiligo patients were diagnosed with one squamous cell carcinoma (SCC), and one patient had one BCC and one SCC. Forty-seven controls were diagnosed with 61 BCCs (23 nodular, eight micronodular, 11 superficial and 19 unspecified); four patients had an SCC.