title: 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.
abstract: BACKGROUND
  The clinical features and the prognostic relevance of vitiligo lesions in melanoma patients are still controversial. This prospective observational study was designed to characterise the clinical features of melanoma-associated vitiligo, to analyse the association with other autoimmune manifestations and to ascertain whether the development of vitiligo lesions carries a prognostic relevance on the clinical course of melanoma.
  
  
  METHODS
  A total of 2954 consecutive patients have been included; multivariate analyses of distant metastasis-free survival (DMFS) and overall survival (OS) were carried out to ascertain the independent prognostic role of vitiligo as a time-dependent covariate.
  
  
  RESULTS
  Vitiligo was demonstrated in 83 of 2954 melanoma patients (2.8%). A significantly higher percentage of autoimmune diseases was demonstrated in vitiligo patients (7 of 83) with respect to patients without vitiligo (80 of 2871) (P = 0.004). Multivariate analyses selected the time-dependent covariate vitiligo as the favourable independent prognostic variable associated to a longer DMFS in stage III and a higher OS in both stage III and stage IV.
  
  
  CONCLUSIONS
  Melanoma-associated vitiligo should be considered as a distinct clinical entity, separate from vitiligo vulgaris, and identifies a subgroup of patients characterised by a high prevalence of immune-mediated diseases and by a favourable prognosis.
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division. Electronic address: pietro.quaglino@unito.it.
authors.forename: P
authors.initials: P
authors.lastname: Quaglino
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division.
authors.forename: F
authors.initials: F
authors.lastname: Marenco
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division.
authors.forename: S
authors.initials: S
authors.lastname: Osella-Abate
authors.affiliation: Department of Genetics, Biology and Biochemistry, University of Turin, Turin, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Cappello
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division.
authors.forename: M
authors.initials: M
authors.lastname: Ortoncelli
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division.
authors.forename: B
authors.initials: B
authors.lastname: Salomone
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division.
authors.forename: M T
authors.initials: MT
authors.lastname: Fierro
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division.
authors.forename: P
authors.initials: P
authors.lastname: Savoia
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Dermatology, First Dermatologic Division.
authors.forename: M G
authors.initials: MG
authors.lastname: Bernengo
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000209:etiology; D014408:Biomarkers, Tumor / Q000032:analysis / Q000502:physiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006761:Hospitals; D006801:Humans; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012878:Skin Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016019:Survival Analysis; D014820:Vitiligo / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor