Skin Cancer and Vitiligo: What’s the Connection?

Aggressive skin cancer (melanoma) and vitiligo are two very different diseases. However, they can occur at the same time. When vitiligo occurs in people with melanoma, it is called melanoma-associated vitiligo.1

Up to 3 out of 100 people with melanoma develop vitiligo. Vitiligo with melanoma makes up fewer than 1 in 100 people with vitiligo. It tends to occur often more in older people.1

The differences between melanoma and vitiligo

Melanoma is an aggressive form of skin cancer. For the last several decades, it has been steadily increasing in Western countries. It can be life-threatening if left untreated.2 Vitiligo is an autoimmune disease. It causes the loss of skin color (pigment) in patches all over the body. These colorless patches can be specific to one area, or they can occur all over the body. They can vary in size and number.3 This loss of skin color happens because the immune system mistakenly attacks the pigment cells (melanocytes) in the skin. Vitiligo is not life-threatening and less common than melanoma. It affects about 2 percent of people worldwide.3

What does it mean to have melanoma-associated vitiligo?

Experts believe that melanoma-associated vitiligo occurs as a result of an immune system response. The immune system detects a foreign, harmful substance (antigen). These antigens are found in the skin cancer cells and normal pigment cells.1,2

Vitiligo in people with melanoma can occur in one of 2 ways:1,2

  • All of a sudden (spontaneous)
  • As a side effect of treatment with immune checkpoint inhibitors (ICIs)

Spontaneous vitiligo with melanoma

Vitiligo can occur suddenly in people with melanoma who are not getting ICI treatment. It can also occur before melanoma is diagnosed.1 In these cases, it can sometimes be hard to know whether someone has normal vitiligo or if it is related to melanoma. This can lead to misdiagnosis and late detection of skin cancer. If you notice any changes in your skin, no matter how small, make an appointment with your dermatologist.1

Vitiligo caused by immune checkpoint inhibitors (ICIs)

ICI therapy is a type of immunotherapy. It stimulates the immune system to target tumors and kill them. ICI therapy is used to treat certain cancers, including melanoma. Vitiligo can occur in up to 1 in 4 people with melanoma who receive ICI therapy.1 In ICI-induced vitiligo, the immune system targets antigens found in the pigment cells of healthy tissue and melanoma tissue. In some cases, vitiligo occurs around the same area as the skin cancer.1 Loss of skin color usually happens around 9 months into receiving ICI treatment. Once treatment is complete, the vitiligo can linger. In some cases, the skin can gain back its color.1

ICI-induced vitiligo may be a good thing

Vitiligo that develops as a result of ICI therapy may be a positive sign. It means that the skin cancer treatment is working.1,2 Melanoma-associated vitiligo is linked to better survival and response rates. If discovered in people with skin cancer, vitiligo can be left alone and should not be treated.1,2

Talk with your doctor

If you are being treated for melanoma and you develop what you think is vitiligo, contact your doctor. They will be able to diagnose and monitor your condition. Improved screening for melanoma-associated vitiligo may lead to more personalized treatment options.1,2

Have you experienced vitiligo alongside skin cancer? Tell us about your experience in the comments

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