Immune Checkpoint Inhibitor–Associated Vitiligo Shows Earlier Onset in Melanoma and Greater Severity With Combination Therapy
A single-institution cohort study provides new insights into the clinical characteristics of immune checkpoint inhibitor (ICI)–associated vitiligo, suggesting differences in onset timing and disease extent based on cancer type and treatment approach.
“Vitiligo is a dermatologic adverse event associated with ICIs,” the investigators noted. However, “the extent, long-term outcomes, and differences between melanoma and non-melanoma cohorts remain poorly defined,” prompting further evaluation.
Researchers queried electronic health records to identify patients diagnosed with vitiligo (ICD-10 L80) while receiving ICIs. Data collected included cancer type, ICI regimen, time to vitiligo onset, disease characteristics, and outcomes.
A total of 140 patients were identified, with a median age of 68 years (range 26–89 years). Most patients had melanoma (74%), while 26% had non-melanoma cancers. Patients receiving combination ICI therapy (33%) demonstrated greater body surface area (BSA) involvement compared with those receiving monotherapy (mean 4.5% vs 2.6%).
Time to vitiligo onset differed by cancer type. Melanoma patients developed vitiligo earlier than non-melanoma patients (mean 286.3 vs 380.5 days), while overall BSA involvement remained similar between groups (mean 3.25% vs 3.23%).
“In this cohort, melanoma patients appeared to develop vitiligo sooner than non-melanoma patients, despite similar overall disease extent,” the authors concluded. “Combination ICI therapy was associated with greater BSA involvement compared with monotherapy, suggesting a more pronounced immune response.”
These findings contribute to a growing understanding of ICI-associated dermatologic adverse events and may inform patient counseling and monitoring strategies in oncology and dermatology practice.
Reference
Lu K, Enriquez K, Dobry A. Characterizing immune checkpoint inhibitor–associated vitiligo: a single-institution cohort. Presented at: American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, Colorado.
