Wang Zhaoyang, Wang Meng, Wang Tianyu, Yan Xiaoxiao, Yue Zhenhua, Sun Yonghu
Dermatology Hospital of Shandong First Medical University, Jinan, China.
Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.
Front Immunol. 2025 Aug 8;16:1625738. doi: 10.3389/fimmu.2025.1625738. eCollection 2025.
Skin depigmentation or vitiligo-like depigmentation (VLD) is one of the most prevalent cutaneous adverse events during targeted therapies for cancers or autoimmune diseases. The depigmentation is usually with high mental burden and affect the disease treatment, some of which are even clinical markers for good prognosis. This study aimed to explore the underlying immunopathologic mechanisms of VLD induced by targeted therapy for cancer and autoimmune disease as well as vaccine, such as immune checkpoint inhibitors (e.g., programmed death 1/programmed death-ligand 1 and cytotoxic T-lymphocyte antigen-4 inhibitors), v-raf murine sarcoma viral oncogene homolog inhibitors, tyrosine kinase inhibitors, and other targeted agents. Additionally, it examined the clinical presentations, prognostic implications, and management strategies for VLD across oncologic and nononcologic contexts, including cases associated with vaccines and biologics. The development of VLD often correlates with improved therapeutic outcomes, but it presents unique challenges in balancing antitumor efficacy with patients' quality of life. This review integrated insights from oncology, dermatology, and immunology, and underscored the need for multidisciplinary approaches to enhance the understanding, prevention, and management of these complex cutaneous adverse events.
皮肤色素脱失或白癜风样色素脱失（VLD）是癌症或自身免疫性疾病靶向治疗期间最常见的皮肤不良事件之一。色素脱失通常会给患者带来沉重的心理负担，并影响疾病治疗，其中一些色素脱失甚至是预后良好的临床标志物。本研究旨在探讨癌症和自身免疫性疾病靶向治疗以及疫苗（如免疫检查点抑制剂，如程序性死亡蛋白1/程序性死亡配体1和细胞毒性T淋巴细胞相关抗原4抑制剂）、v-raf鼠肉瘤病毒癌基因同源物抑制剂、酪氨酸激酶抑制剂和其他靶向药物诱导VLD的潜在免疫病理机制。此外，研究还考察了肿瘤学和非肿瘤学背景下VLD的临床表现、预后意义及管理策略，包括与疫苗和生物制剂相关的病例。VLD的发生往往与治疗效果改善相关，但在平衡抗肿瘤疗效与患者生活质量方面带来了独特挑战。本综述整合了肿瘤学、皮肤病学和免疫学的见解，并强调需要采取多学科方法来加强对这些复杂皮肤不良事件的理解、预防和管理。
