Multinational retrospective study of immune checkpoint inhibitor-induced vitiligo-like depigmentation

Vitiligo-like depigmentation (VLD) is a common immune-related adverse event (irAE) associated with immune checkpoint inhibitors (ICIs). A multinational retrospective study investigated clinical features of ICI-induced VLD. The study included adult patients with metastatic cancer receiving ICI therapy, who developed VLD due to ICI monotherapy and patients with preexisting vitiligo experiencing a worsening of at least 15% in body surface area (BSA) score after starting therapy. A total of 200 patients were included (120 men and 80 women) with a median age of 61 years (range 53-71). Patients with melanoma comprised 77.5% of the cohort. VLD developed a median of 8.1 months (range 1-44) after ICI initiation. The most common clinical features reported were a speckled pattern of VLD (34.5% of patients), lesions primarily limited to sun-exposed areas (53.5%), and BSA score lower than 15 (92.5%). Preexisting erythematous inflammatory lesions preceded VLD development in 34.5%. In 140 of 200 patients, less than 10% BSA was affected. In VLD management, 56.5% of patients declined specific therapy. Only patients discontinuing ICIs saw stabilization (in one patients regression) of VLD. In addition to VLD, patients reported xerosis (35%) and pruritus. The authors conclude that the study provides clinical data of patients with ICI-induced VLD.