Melanoma — SCE Dermatology MCQ
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Correct answer: D — It is associated with better tumour response and improved survival
Vitiligo-like depigmentation during checkpoint inhibitor therapy for melanoma is a favourable prognostic sign, associated with better tumour response and improved overall survival. The mechanism involves immune-mediated destruction of melanocytes (both malignant melanoma cells and normal melanocytes sharing common antigens). Other dermatological immune-related adverse events (lichenoid eruptions, psoriasiform eruptions) also correlate with better anti-tumour responses. Vitiligo-like depigmentation does not require treatment cessation. Management is sun protection and cosmetic camouflage if desired by the patient.
Reference: NICE NG14 Melanoma; BJD 2019 irAE and prognosis