The Relationship between melanoma and vitiligo
Vitiligo is a chronic systemic acquired disease that has an unforeseeable clinical course, characterized by the occurrence of macules and achromic or hypochromic patches on the skin and mucous membranes due to the vanishing of melanocytes in the affected area. Along with the skin and mucosal involvement, melanocytes in the ocular ( mostly in the uveal tract) and auditory apparatus (in vascular streaking and the modiolus of the cochlea) can be reduced, ocular diseases such as uveitis or even neurosensorial hearing loss may also occur. Yet, Psychological impact is one of the main outcomes of the disease, ago vitiligo can have strong effects on patients 'self-respect, with an increase in severe depression cases and a sharp sense of social discrimination resulting in quality of life deterioration(3). Melanoma is one of the most common malignant skin tumors with permanently rising incidence worldwide, essentially in fair-skinned populations ( 2). It is usually diagnosed at an average age 50, but for the time being is also diagnosed more frequently in younger adults, and very seldom in childhood.
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Cutaneal skin cancer represents the foremost aggressive sort of carcinoma, whereas vitiligo is an autoimmune disorder that results in progressive destruction of skin melanocytes. However, vitiligo has been related to cutaneous melanoma since the 1970s. Most of the antigens recognized by the immune system are expressed by each melanoma cells and traditional melanocytes, explaining why the autoimmune response against melanocytes that led to vitiligo could be also present in melanoma patients. Leukoderma has been also observed as a side effect of melanoma immunotherapy and has always been associated with a favorable prognosis. During this report, we tend to discuss several characteristics of the immune system responses shared by melanoma and vitiligo patients, also because of the significance of the incidence of leukoderma throughout immunotherapy, with special attention to checkpoint inhibitors.
