Is a History of Malignant Melanoma Associated with Subsequent Vitiligo? Insights from a Population-Based Case–Control Study

TL;DR

This study finds that a history of melanoma is generally not linked to a higher risk of vitiligo, except in the Arab population, where the risk is six times higher.

Contribution

The study provides population-based evidence of a strong association between melanoma and vitiligo specifically in the Arab minority.

Findings

Preexisting melanoma prevalence was similar between vitiligo patients and controls (0.30% vs. 0.35%).

A history of melanoma was not significantly associated with vitiligo in the general population (OR 1.03).

Arab individuals with melanoma had a sixfold higher likelihood of developing vitiligo (OR 6.55).

Abstract

Background: While a few studies suggest that depigmentation tends to develop more frequently in patients with malignant melanoma (MM), the association between vitiligo and MM has been sparsely investigated in the setting of controlled studies. Methods: A population-based case–control study compared 14,632 patients with vitiligo with 71,580 control subjects matched by age, sex, and ethnicity regarding the prevalence of preexisting MM. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals (CIs) of developing vitiligo both in univariate and multivariate models, adjusting for demographic variables and comorbidities. The OR was also stratified by age, sex, ethnicity, and ultraorthodox status. Results: The prevalence of preexisting MM was statistically comparable between individuals with vitiligo and controls (0.30% vs. 0.35%, respectively). In the general study population, a history of MM was not significantly associated with an elevated likelihood of developing vitiligo (multivariate OR, 1.03; CI 95%, 0.76–1.40). Among the Arab population, however, preexisting MM was associated with a sixfold-increased likelihood of subsequent vitiligo (univariate OR, 6.55; 95% CI, 1.46–29.27). Patients with vitiligo and comorbid MM were older at the onset of vitiligo, had a higher burden of comorbid conditions, and showed an overrepresentation of Jewish ancestry. Conclusions: A history of MM does not increase the probability of vitiligo in the general Israeli population, except among the Arab minority, who show a sixfold-elevated odds of vitiligo after MM. Further investigation is essential to gain deeper insights into this relationship.