Side Effect: Loss of Pigmentation (Vitiligo)

Vitiligo is a skin condition characterized by the loss of pigmentation in patches of skin due to the destruction of melanocytes, the cells responsible for producing skin pigment. The cause of vitiligo is believed to involve an autoimmune process where the body's immune system attacks and destroys melanocytes.

Vitiligo typically appears as depigmented patches of skin on the face, arms, hands, and other areas where there is friction to the skin. The patches can vary in size and shape and may appear as sharply defined borders or gradually fade into the surrounding skin.

• Vitiligo is the most common skin pigmentation disorder and affects 0.5-2% of people worldwide.
  
  
• Patients with cancer may develop vitiligo as a side effect of certain chemotherapy and immunotherapy treatments.
  
  
• Vitilgo may occur in as many 25% (one out of every 4 people) of patients receiving immunotherapy treatments. With immunotherapy treatments, vitiligo may not appear until months after starting treatment. The appearance of vitiligo has been linked with better treatment response in some cancers such as melanoma.

The treatment of vitiligo in cancer patients can be challenging as it does not usually resolve after stopping the causative treatments and certain treatments for vitiligo may be contraindicated.

In general, it is recommended to avoid exposure to sunlight and to keep affected areas covered. Topical treatments that decrase the immune system response, such as hydrocortisone (a corticosteroid), may used but only after approved by your doctor. If appropriate, alternative treatments that may be considered include phototherapy, systemic corticosteroids (such as prednisone pills), surgical grafting, or depigmentation treatments.