MONDAY, Dec. 23, 2024 -- In a research letter published online Dec. 23 in JAMA Dermatology, investigators present the results from a case-series study of vitiligo-like depigmentation (VLD) in a cohort of 200 adults with metastatic cancer receiving immune checkpoint inhibitors (ICIs).

Michela Starace, M.D., Ph.D., from IRCCS Azienda Ospedaliero-Universitaria di Bologna in Italy, and colleagues examined the epidemiologic and clinical features of ICI-induced VLD in a multicenter, retrospective study of patients with metastatic cancer.

Two hundred patients were included: 77.5 percent with melanoma and 23.0 percent with nonmelanoma cancers. The researchers found that VLD developed a median of 8.1 months after initiation of ICI. A speckled pattern of VLD, lesions primarily limited to sun-exposed areas, and body surface area score lower than 15 were the most common clinical features (34.5, 53.5, and 82.5 percent, respectively). In 34.5 percent of patients, preexisting erythematous inflammatory lesions preceded VLD development. Overall, 43.5 percent of patients had thyroid toxicity from ICIs. More localized VLD was exhibited in the cohort; in 140 of the patients, less than 10 percent body surface area was affected. In terms of management, 56.5 percent of patients declined specific therapy. Stabilization or regression of VLD only occurred in patients discontinuing therapy.

"Results of this case-series study enhance the understanding of immune-related VLD," the authors write. "The inclusion of diverse cancer types and elucidation of the clinical characteristics of VLD in 200 patients may help increase knowledge of the care of patients undergoing ICI cancer treatment."

Several authors disclosed ties to the pharmaceutical industry.