Malignant Melanoma and Vitiligo

SUMMARY Eleven patients suffering from malignant melanoma have been found to have varying degrees of vitiligo. The association of the two conditions may be purely coincidental; however, there are several features both of melanoma and of the vitiligo in these patients which suggest that there could be some relationship between the behaviour of melanoma and the development of vitiligo. The cases are reported with a view to pooling experience of a rare association of events. Depigmentation associated with malignant melanoma may take one of several forms, Milton (1969); the primary lesion may undergo total spontaneous regression leaving an amelanotic scar; all or part of a growing primary lesion may become amelanotic; the skin in the immediate vicinity of a primary melanoma may become amelanotic. Metastatic melanoma can also be associated with depigmentation because the deposits themselves are quite often amelanotic and rarely skin secondaries may show pale halos of depigmentation. The pale halos often develop after successful chemotherapeutic treatment or, on rare occasions, spontaneously. This paper presents eleven cases of depigmentation (vitiligo) which was not closely related to either the primary lesions or to metastases. The clinical course of some of these cases was unusual and a speculation is advanced that vitiligo associated with malignant melanoma may have some bearing on the prognosis of the disease. It is hoped that the publication of this report will stimulate a search for cases in which a possible correlation between vitiligo and malignant melanoma can be either proved or disproved.