Race-specific risk profiles: Vitiligo as a protective factor against cutaneous malignancies
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Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: Abstract Body: This study evaluates the relative risk of melanoma and non-melanoma skin cancer(NMSC) in White versus Black individuals with vitiligo, a common depigmenting disorder marked by melanocyte destruction. Despite concerns about increased skin cancer risk due to melanin loss in vitiligo, genetic evidence indicates lower melanoma susceptibility. Epidemiological studies show varied melanoma and NMSC risks in vitiligo patients, potentially linked to autoimmunity, with pigmentation factors individually accounting for less than 1% of skin cancer variance. Using the TriNetX Research database, with electronic medical records from 105 healthcare organizations, White and Black/African American individuals diagnosed with vitiligo were separated into cohorts using specific ICD-10 codes. Comparative analyses of hazard ratios (HR) with 95% confidence intervals(CI) were performed for various cutaneous malignancy outcomes from 1-day post-diagnosis onward. Cohorts were matched for age, ethnicity, and gender using a propensity score model. Statistical significance was defined as p<0.05. White vitiligo patients exhibited significantly higher incidences of the following cutaneous malignancies compared to Black vitiligo patients: All malignant neoplasms of skin: HR [95% CI] = 9.035 [6.539, 12.482], p<0.0001 Melanoma: HR [95% CI] = 7.798 [5.769, 10.54], p<0.0001 Squamous cell carcinoma: HR[95% CI] = 5.743 [2.83, 11.653], p<0.0001 Basal cell carcinoma: HR[95% CI] = 22.509 [8.268, 61.28], p<0.0001 Actinic keratoses: HR [95% CI] = 16.788 [12.241, 23.024], p<0.0001. These findings suggest differing immune effects on melanocytes in White versus Black patients, which may underlie vitiligo's protective role against skin cancer and guide clinical recommendations for skin cancer prevention in individuals with vitiligo. Alekhya Gurram<sup>1</sup>, George Golovko<sup>2</sup>, Michael G. Wilkerson<sup>4</sup>, Amina El Ayadi<sup>3</sup> 1. The University of Texas Medical Branch John Sealy School of Medicine, Galveston, TX, United States. 2. Pharmacology and Toxicology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States. 3. Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX, United States. 4. Dermatology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States. Pigmentation, Melanoma, and Melanoma Immune Surveillance