Vitiligo in the affected breast during neo-adjuvant chemotherapy for breast cancer.
ABSTRACT Dear Editor, We describe here a patient with breast cancer who developed vitiligo in the cancer-affected breast and axilla during neoadjuvant chemotherapy. A 41-year-old premenopausal woman was diagnosed with clinical stage II breast cancer after she discovered a left breast mass. Physical examination revealed a freely mobile 3 cm mass in the left breast 12 o’clock position and an area of induration in the left axilla. There were no associated skin changes. Biopsy of the breast mass confirmed hormone-receptor positive, highgrade invasive ductal carcinoma. A fine needle aspiration of the left axillary lymph node was also positive for carcinoma. The patient had a history of intermittent vitiligo which was not evident on skin examination at the time of diagnosis of breast cancer. She was treated with 4 cycles of
Article: The isomorphic response of Koebner.International Journal of Dermatology 07/1990; 29(6):401-10. DOI:10.1111/j.1365-4362.1990.tb03821.x · 1.23 Impact Factor
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ABSTRACT: We have identified and studied twenty-seven patients with melanoma who also had vitiligo. Four patients had vitiligo before the diagnosis of melanoma, and twenty-three developed depigmentation after the diagnosis of malignancy. We also have reviewed published reports about twenty-four other patients with melanoma who developed vitiligo. The clinical course of the melanoma in the fifty-one patients was remarkably similar. Thirty-seven had a melanoma arising at a site which tends to carry a poor prognosis, for example, on the trunk, under the nail, or on the mucous membranes. Forty-nine patients had metastases in regional lymph nodes or at distal sites. Thirty-three patients survived 5 years, and twenty-five survived 10 years. These data suggest that the appearance of vitiligo in patients with metastatic melanoma portends a longer survival than expected. The patients with vitiligo are not necessarily cured and eventually may succumb to metastatic disease. We were unable to determine whether the vitiligo caused retardation of tumor growth or whether the melanoma caused vitiligo.Journal of the American Academy of Dermatology 12/1983; 9(5):689-96. DOI:10.1016/S0190-9622(83)70182-9 · 5.00 Impact Factor
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ABSTRACT: Cancer cells express self-antigens that are weakly recognized by the immune system. Even though responses against autologous cells are difficult to induce, the immune system is still able to mount a response against cancer. The discovery of the molecular identity of antigens that are recognized by the immune system of melanoma patients has led to the elucidation of tumor immunity at a cellular and molecular level. Multiple pathways in both the priming and effector phases of melanoma rejection have been described. Animal models' active immunotherapies for melanoma show a requirement for the cellular compartment of the immune system in the priming phase, primarily CD4+T cells. More diverse elements are required for the effector phase, including components from the innate immune system (macrophages, complement and/or natural killer cells) and from the adaptive immune system (CD8+T cells and B cells). Minor differences in amino-acid sequences of antigens must determine the particular mechanisms involved in tumor rejection. Since the immune system contains T and B cells that recognize and reject autologous cells, a consequence of tumor immunity is potential autoimmunity. There are distinct pathways for tumor immunity and autoimmunity. The requirements for autoimmunity at the priming phase seem to be CD4+/IFN-gamma dependent while the effector mechanisms are alternative and redundant. Vitiligo (autoimmune hypopigmentation) can be mediated by T cells, FcgammaR+macrophages and/or complement.Oncogene 06/2003; 22(20):3180-7. DOI:10.1038/sj.onc.1206462 · 8.56 Impact Factor