PROGNOSTIC-SIGNIFICANCE OF CUTANEOUS DEPIGMENTATION IN MEXICAN PATIENTS WITH MALIGNANT-MELANOMA

Background: The clinical significance of cutaneous depigmentary phenom ena in patients with malignant melanoma is not clear. There are two va rieties: 1) vitiligo (VIT), and 2) leukoderma acquisitum centrifugum ( LAC), Methods: In order to evaluate the outcome of our patients with m alignant melanoma and skin depigmentation (VIT or LAC), the patients i n this study with this association were retrospectively reviewed and c ompared with the total melanoma patients at the Oncology Hospital and the XXI Century National Medical Center of the Mexican Social Security Institute in Mexico City. Results: Nine cases were found from 1985 - 1995, There were eight women and one man, their mean age was 63 years. Six melanomas were located in the foot, one in the leg, one in the an us and one in the neck. All were Clark's levels III, IV or V, and thei r mean tumor thickness was 5.7 mm, Four out of nine patients had regio nal lymph node metastasis. Six melanomas were associated with VIT and three with LAC. Three patients developed the depigmentation after chem o- or chemoimmunotherapy, All nine patients are alive (100%) with a me an follow-up of 55 months (9-141), eight out of nine have no evidence of tumor. Conclusions: From these data it may be concluded that the st udy patients with malignant melanoma and VIT or LAC have a higher-than -expected survival according to their prognostic factors. Therefore, t he presence of the depigmentation phenomena must be looked for intenti onally.