Vitiligo and melanoma-associated hypopigmentation (MAH): shared and discriminative features.
BACKGROUND
It is unclear if differences between melanoma-associated hypopigmentation (MAH) and classical vitiligo exist.


METHODS
Hypopigmented areas and associated lesions (halo nevi, hypopigmented scars) in 15 melanoma patients and 31 patients with classical vitiligo were analyzed by digital photography. The activity of the respective lesions was assessed by the vitiligo disease activity (VIDA) score. Associated diseases were recorded by history and serological tests;genotyping of HLA class I antigens as well as histology/immunohistology were performed.


RESULTS
MAH were diagnosed in 12 of 15 melanoma patients; mean onset was 4.8 years after the primary diagnosis of the melanoma. Three melanoma patients reported hypopigmentation more than 15 years before diagnosis of melanoma. In the history and family history of vitiligo patients, autoimmune diseases were much more frequent and haplotype HLA-A2 was twice as common compared to MAH patients. MAH lesions were most often distributed in a bilateral symmetrical pattern, corresponding to vitiligo. MAH was less progressive compared to classical vitiligo; however, it was more often associated with other acquired leukodermas. In both groups hypopigmentation spread centripetally to the trunk. Histological and immunohistological differences were not found.


CONCLUSIONS
Whereas differences exist concerning associated autoimmune diseases, MAH and vitiligo shared many common clinical and histological features. Further studies are needed to assess the clinical relevance of vitiligo-like alterations in melanoma patients.
Hartmann
Anke
A
Deparment of Dermatology, Venerology and Allergology, University of Würzburg, Germany.
Bedenk
Christina
C
Keikavoussi
Petra
P
Becker
Jürgen C
JC
Hamm
Henning
H
Bröcker
Eva-Bettina
EB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017496:Hypopigmentation / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000175:diagnosis*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000209:etiology*; D014820:Vitiligo / Q000175:diagnosis*