Prognostic significance of cutaneous depigmentation in Mexican patients with malignant melanoma.

BACKGROUND

The clinical significance of cutaneous depigmentary phenomena in patients with malignant melanoma is not clear. There are two varieties: 1) vitiligo (VIT), and 2) leukoderma acquisitum centrifugum (LAC).

METHODS

In order to evaluate the outcome of our patients with malignant melanoma and skin depigmentation (VIT or LAC), the patients in this study with this association were retrospectively reviewed and compared with the total melanoma patients at the Oncology Hospital and the XXI Century National Medical Center of the Mexican Social Security Institute in Mexico City.

RESULTS

Nine cases were found from 1985-1995. There were eight women and one man, their mean age was 63 years. Six melanomas were located in the foot, one in the leg, one in the anus and one in the neck. All were Clark's levels III, IV or V, and their mean tumor thickness was 5.7 mm. Four out of nine patients had regional lymph node metastasis. Six melanomas were associated with VIT and three with LAC. Three patients developed the depigmentation after chemo- or chemoimmunotherapy. All nine patients are alive (100%) with a mean follow-up of 55 months (9-141), eight out of nine have no evidence of tumor.

CONCLUSIONS

From these data it may be concluded that the study patients with malignant melanoma and VIT or LAC have a higher-than-expected survival according to their prognostic factors. Therefore, the presence of the depigmentation phenomena must be looked for intentionally.