Vitiligo after immune checkpoint inhibitor therapy in a woman with metastatic melanoma

Historically, the median overall survival of patients with metastatic melanoma was less than one year. The recent advent of immunotherapy has changed the outlook dramatically and made long-term disease control achievable. Nivolumab, a monoclonal antibody to programmed cell death 1 (anti-PD1), has been proved to prolong survival in patients with metastatic melanoma. Vitiligo is a skin disorder characterized by the loss of color, and the postulated mechanism is immune-mediated destruction of melanocytes. Anti-PD1 treatment related to vitiligo has been reported to be associated with a favorable response in patients with melanoma. Here we present the case of a 61-year-old woman who received nivolumab for metastatic melanoma. After 6 months of nivolumab therapy, the patient experienced scattered hypopigmentation on her face, chest, and back. Durable response was noticed according to the follow-up images even after nivolumab was discontinued. Keywords: Immunotherapy, Melanoma, Vitilig