Reduced risk of keratinocyte carcinoma in vitiligo

Patients with vitiligo do not have an increased risk of developing non-melanoma skin cancer. A recent meta-analysis shows a lower relative risk of developing keratinocyte carcinoma in patients with vitiligo compared with healthy controls. What is the mechanism behind this?

Alex Rucker, a doctoral student at the Medical University of Amsterdam, and colleagues examined the risk of non-melanoma skin cancer in patients with vitiligo in a systematic review and meta-analysis. They found a relatively reduced risk of keratinocyte carcinoma (KC) in people with vitiligo. Curious about the mechanisms behind this, Rucker formulated a number of hypotheses, including immunological and non-immunological mechanisms.

“The autoimmune reaction associated with vitiligo is directed against melanocytes, but also against skin cancer.”

Immune protection

Patients with vitiligo have immune protection against skin cancer. Epidemiological studies show a lower incidence of melanoma in patients with vitiligo. Conversely, some patients with skin cancer develop vitiligo after immunotherapy. The autoimmune reaction associated with vitiligo is directed against melanocytes, but also against skin cancer.

In the absence of pigment, keratinocyte carcinoma is expected to arise from a different type of cell. You can see this in people with fair skin, but also in people with albinism. So it seems that there is a mechanism other than pigmentation, which is patting