PMID- 27717621
OWN - NLM
STAT- MEDLINE
DCOM- 20170419
LR  - 20170817
IS  - 1097-6787 (Electronic)
IS  - 0190-9622 (Linking)
VI  - 75
IP  - 6
DP  - 2016 Dec
TI  - Melanoma-associated leukoderma and vitiligo cannot be differentiated based on
      blinded assessment by experts in the field.
PG  - 1198-1204
LID - S0190-9622(16)30614-4 [pii]
LID - 10.1016/j.jaad.2016.07.060 [doi]
AB  - BACKGROUND: Melanoma-associated leukoderma (MAL) is a depigmenting disorder that 
      can occur spontaneously in patients with melanoma. The differences in clinical
      presentation between MAL and vitiligo are not well defined. This may lead to
      misdiagnosing MAL as vitiligo, resulting in delayed detection of melanoma.
      OBJECTIVE: The objective of this study was to assess whether experts in the field
      can distinguish between MAL and vitiligo, and to assess if discriminative
      features can be identified. METHODS: We designed an image comparison study in
      which 4 experts in the field blindly assessed photographs followed by medical
      history of 11 patients with MAL and 33 with vitiligo. RESULTS: The assessors
      misdiagnosed 72.7% of MAL cases and marked 80.0% of them as typical vitiligo. The
      median age at onset of the leukoderma was higher (55 years, P = .001) in MAL. No 
      discriminative features were found. LIMITATIONS: Sampling bias because of
      inclusion in tertiary referral center is a limitation. CONCLUSION: The clinical
      presentation of leukoderma in patients with melanoma resembles that of vitiligo. 
      We propose "melanoma-associated vitiligo" as the more appropriate term for
      leukoderma in patients with melanoma. Clinicians should be aware that
      depigmentation in vitiligo can also be caused by melanoma-associated vitiligo and
      a total body inspection should be performed.
CI  - Copyright (c) 2016 American Academy of Dermatology, Inc. Published by Elsevier
      Inc. All rights reserved.
FAU - Lommerts, Janny E
AU  - Lommerts JE
AD  - Netherlands Institute for Pigment Disorders and Department of Dermatology,
      Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
      Electronic address: j.e.lommerts@amc.nl.
FAU - Teulings, Hansje-Eva
AU  - Teulings HE
AD  - Netherlands Institute for Pigment Disorders and Department of Dermatology,
      Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
FAU - Ezzedine, Khaled
AU  - Ezzedine K
AD  - Epidemiologie en Dermatologie et Evaluation des Therapeutiques, Universite
      Paris-Est, Service de Dermatologie, Hopital Henri Mondor, Paris, France.
FAU - van Geel, Nanja
AU  - van Geel N
AD  - Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
FAU - Hartmann, Anke
AU  - Hartmann A
AD  - Department of Dermatology, University of Erlangen, Erlangen, Germany.
FAU - Speeckaert, Reinhart
AU  - Speeckaert R
AD  - Department of Dermatology, Ghent University Hospital, Ghent, Belgium.
FAU - Spuls, Phyllis I
AU  - Spuls PI
AD  - Netherlands Institute for Pigment Disorders and Department of Dermatology,
      Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
FAU - Wolkerstorfer, Albert
AU  - Wolkerstorfer A
AD  - Netherlands Institute for Pigment Disorders and Department of Dermatology,
      Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
FAU - Luiten, Rosalie M
AU  - Luiten RM
AD  - Netherlands Institute for Pigment Disorders and Department of Dermatology,
      Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
FAU - Bekkenk, Marcel W
AU  - Bekkenk MW
AD  - Netherlands Institute for Pigment Disorders and Department of Dermatology,
      Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20161004
PL  - United States
TA  - J Am Acad Dermatol
JT  - Journal of the American Academy of Dermatology
JID - 7907132
SB  - IM
MH  - Adult
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Hypopigmentation/*diagnosis/etiology
MH  - Male
MH  - Medical History Taking
MH  - Melanoma/complications/*diagnosis
MH  - Middle Aged
MH  - Observer Variation
MH  - Photography
MH  - Sensitivity and Specificity
MH  - Single-Blind Method
MH  - Skin Neoplasms/complications/*diagnosis
MH  - Vitiligo/diagnosis
OTO - NOTNLM
OT  - *clinical presentation
OT  - *depigmentation
OT  - *diagnostic accuracy
OT  - *melanoma
OT  - *melanoma-associated hypopigmentation
OT  - *melanoma-associated leukoderma
OT  - *melanoma-associated vitiligo
OT  - *vitiligo
EDAT- 2016/10/09 06:00
MHDA- 2017/04/20 06:00
CRDT- 2016/10/09 06:00
PHST- 2016/04/26 00:00 [received]
PHST- 2016/07/28 00:00 [revised]
PHST- 2016/07/30 00:00 [accepted]
PHST- 2016/10/09 06:00 [pubmed]
PHST- 2017/04/20 06:00 [medline]
PHST- 2016/10/09 06:00 [entrez]
AID - S0190-9622(16)30614-4 [pii]
AID - 10.1016/j.jaad.2016.07.060 [doi]
PST - ppublish
SO  - J Am Acad Dermatol. 2016 Dec;75(6):1198-1204. doi: 10.1016/j.jaad.2016.07.060.
      Epub 2016 Oct 4.