Case Reports
17 April 2025
Early Access
https://doi.org/10.4081/dr.2025.10125

Acral lentiginous melanoma with subsequent spontaneous vitiligo vulgaris: a case report and literature review

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Malignant melanoma, acral lentiginous melanoma, vitiligo vulgaris, generalized vitiligo, leukoderma, depigmentation
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Authors

Ronak Saeed Ahmed
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; Dermatology Teaching Center for Treating Skin Diseases, Sulaimani Directorate of Health, Sulaymaniyah, Iraq.
Rozhgar Rashid Ali
College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.
Dilan S. Hiwa
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Iraq.
Abdullah K. Ghafour
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah, Iraq.
Shvan Omar Siddiq
Dermatology Teaching Center for Treating Skin Diseases, Sulaimani Directorate of Health, Sulaymaniyah; Kurdistan Board of Medical Specialties, Erbil, Iraq.
Saywan K. Asaad
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.
Ari M. Abdullah
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; Department of Pathology, Sulaymaniyah Teaching Hospital, Iraq.
Rawa M. Ali
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; Department of Histopathology, Hospital for Treatment of Victims of Chemical Weapons, Halabja, Iraq.
Zuhair D. Hammood
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; Kscien Organization, Sulaymaniyah, Iraq.
Rebaz M. Ali
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; Hiwa Hospital, Ministry of Health, Sulaymaniyah, Iraq.
Fahmi H. Kakamad
fahmi.hussein@univsul.edu.iq
https://orcid.org/0000-0002-2124-9580
Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.

Acral lentiginous melanoma (ALM) is an infrequent and often missed subtype of melanoma. Its association with spontaneous vitiligo vulgaris is an exceedingly rare condition. The current study presents a rare case of ALM with spontaneous vitiligo vulgaris after complete resection of the ALM. An 84-year-old male patient presented with multiple white skin lesions on the scalp, neck, trunk, and upper and lower limbs for a three-month duration. One year prior, a diagnosis of ALM was confirmed on histopathological examination with a pathological stage of T4bNxMx. The patient did not receive any treatment until the time of presentation, apart from the surgical removal of the primary tumor. No treatment was advised for the patient’s vitiligo vulgaris; only observation was recommended. Clinical diagnosis of vitiligo vulgaris was made with the association of ALM. In the literature review, only several case reports of vitiligo were attributed to ALM, especially without the use of immunotherapeutic agents. Melanoma represents a notably immunogenic malignancy, provoking both humoral and cellular responses from the immune system directed against cytoplasmic and membrane antigens of melanocytes. There is a suggestion that normal melanocytes might function as neutral observers and become targets of immune responses directed against melanoma cells, leading to melanoma-associated vitiligo. It occurs more commonly as a consequence of immunologic-based therapeutic interventions or after metastatic melanoma; however, the occurrence of spontaneous vitiligo vulgaris several months following complete surgical removal of ALM is possible.

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Zuhair D. Hammood, Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; Kscien Organization, Sulaymaniyah

Department of Surgery, Tikrit Teaching Hospital, Saladin, Iraq.

Fahmi H. Kakamad, Scientific Affairs Department, Smart Health Tower, Sulaymaniyah; College of Medicine, University of Sulaimani, Sulaymaniyah

Kscien Organization, Sulaymaniyah, Iraq.

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Acral lentiginous melanoma with subsequent spontaneous vitiligo vulgaris: a case report and literature review. (2025). Dermatology Reports. https://doi.org/10.4081/dr.2025.10125
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