AI Article Synopsis

  • Vitiligo patients typically have fewer melanocytes, which theoretically increases their risk for non-melanoma skin cancers, but studies in Caucasians have shown lower incidences of such cancers in these patients.
  • A rare case in India describes an older woman with long-standing vitiligo who developed actinic keratoses and squamous cell carcinoma in sun-exposed vitiligo patches, highlighting a need for more local research.
  • The patient received treatment for her lesions and was advised on lifestyle changes, emphasizing the importance of sunscreen use and protective clothing, especially considering many Indian patients may not prioritize sun protection due to financial limitations.

Article Abstract

Vitiligo skin has a lesser number of photoprotective melanocytes-theoretically, there is a higher risk of development of non-melanoma skin cancers in such patients. But most studies in Caucasian patients have shown decreased incidence of non-melanoma skin cancers in patients with vitiligo. In Indian patients, there is a paucity of literature on such adverse events. We report a case of actinic keratoses, cutaneous horn with dysplasia and squamous cell carcinoma developing exclusively over photo-exposed vitiligo lesions in an Indian woman in her 60s (housewife, Fitzpatrick skin type V and average daily photo-exposure time 2-4 hours) of long-standing vitiligo vulgaris without any history of phototherapy. The photoprotected lesional skin was completely normal with no clinically appreciable enlarged regional lymph nodes. Shave and elliptical excision of the suspicious lesions were done, and histopathology showed various degrees of malignant transformation in various lesions. The patient was started on topical imiquimod for the lesions of actinic keratoses and was referred for staging and wide excision of squamous cell carcinoma lesion. We report this case for its rarity and to emphasise the fact that there is a need for counselling for lifestyle modification in patients with vitiligo as the use of sunscreens is often not practised by Indian patients due to financial constraints and physical measures such as using full sleeves, high-collared dresses and scarves should be encouraged.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10826530PMC
http://dx.doi.org/10.1136/bcr-2023-255306DOI Listing

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