Vitiligo-like Depigmentation Associated with Metastatic Melanoma of an Unknown Origin

Although malignant melanoma usually occurs after the diagnosis of vitiligo-like depigmentation, the latter is rarely followed by the former. We herein report on such a case in which recognition of the vitiligo-like depigmentation preceded diagnosing the metastatic melanoma by several months. A 56-year-old woman had first developed vitiligo-like depigmentation on the forehead, eyelids, neck and back 18 months previously and thereafter she detected a hard mass in the left axilla 2 months previously. Based on the histologic findings, the axillary mass was diagnosed as metastatic melanoma. To evaluate the primary tumor focus, thorough examinations that included PET-CT, bone scan and sigmoidoscopy were performed, but we couldn`t find any the original primary tumor. Our case suggests that the vitiligo-like depigmentation could be a sign that heralds metastatic melanoma.

Two cases of nickel dermatitis showing vitiligo-like depigmentations

The authors reviewed two patients showing "vitiligo-like depigmentations" where the skin had been in close contact with a metal spectacle frame made of nickel alloy. In spite of the hypersensitivity to nickel in both patients, they showed clinical and histologic findings indicate that the formation of "vitiligo-like depigmentation" does not result from posinflammatory hypopigmentation but from chemical hypomelanosis. We could not explain the underlying mechanisms; however, the speculation that the "vitiligo-like depigmentation" may come from the direct effect of the nickel itself, prompted us to report these cases.