title: Immunotherapy-induced leukoderma from treatment of melanoma with IL-2: a case report and a review of the literature.
abstract: Melanoma-associated leukoderma (MAL) is a relatively uncommon phenomenon in the literature that can present (1) before melanoma detection, (2) after detection and before treatment, and (3) after treatment with immunotherapeutic agents. We report a case of MAL in an 83-year-old man after treatment with high dose IL-2 for metastatic melanoma and further describe the literature of the underlying mechanisms behind it that involve the immune system. Cytotoxic CD8+ T cells are thought the mediate the process at a cellular level. Self-antigens (e.g. MART-1/2, gp100, tyrosinase) have been presented on the surface of both normal and malignant melanocytes and mediate the development of MAL after cytotoxic CD8+ T cells attack both cell types. Autoimmune manifestations have a positive effect on tumor immunity, with patients at stage III and stage IV melanoma showing a better prognosis after leukoderma development. In addition, immunotherapy induced leukoderma has been associated with a higher therapeutic response rate. Recently, newer immuno-therapeutic drugs, such as vemurafenib and ipilimumab, have been associated with leukoderma as a side effect.
authors.affiliation: School of Medicine, University of Mississippi Medical Center, 39216 Jackson, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gathings
authors.forename: Robin
authors.initials: R
authors.lastname: Lewallen
authors.forename: Gil
authors.initials: G
authors.lastname: Yosipovitch
mesh_terms: D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D015551:Autoimmunity / Q000187:drug effects; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects*; D007376:Interleukin-2 / Q000009:adverse effects*; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000276:immunology / Q000556:secondary; D009367:Neoplasm Staging; D010859:Pigmentation Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D012880:Skin Pigmentation / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007376:Interleukin-2