Aim: To investigate the prevalence and clinical characteristics of vitiligo after allogeneic hematopoietic cell transplantation (AHCT). Methods: The development of vitiligo was analyzed among 421 patients who underwent AHCT in Ibni Sina Hospital (University of Ankara) between 1988 and 2004. Results: Among 421 patients, we describe 6 with generalized vitiligo occurring after AHCT for chronic myelogenous leukemia. Five of them had severe chronic graft-versus-host disease (GVHD). Vitiligo was accompanied by alopecia areata and acquired ichthyosis in 2 patients with GVHD. Conclusion: Melanocyte destruction caused by the autoimmune reactions triggered by chronic GVHD as well as a genetic predisposition might have played a role in the development of vitiligo in our patients. These data support the hypothesis that vitiligo is an autoimmune entity.

Kemp EH, Waterman EA, Weetman AP: Autoimmune aspects of vitiligo. Autoimmunity 2001;34:65–77.
Hegedus L, Heidenheim M, Gervil M, Hjalgrim H, Hoier-Madsen M: High frequency of thyroid dysfunction in patients with vitiligo. Acta Derm Venereol 1994;74:120–123.
Alkhateeb A, Fain PR, Thody A, Bennett DC, Spritz RA: Epidemiology of vitiligo and associated autoimmune diseases in Caucasian probands and their families. Pigment Cell Res 2003;16:208–214.
Sharma VK, Dawn G, Kumar B: Profile of alopecia areata in Northern India. Int J Dermatol 1996;35:22–27.
Nagler A, Goldenhersh MA, Levi-Schaffer F, Bystryn JC, Klaus SN: Total leucoderma: a rare manifestation of cutaneous chronic graft-versus-host disease. Br J Dermatol 1996;134:780–783.
Aubin F, Cahn JY, Ferrand C, Angonin R, Humbert P, Tiberghien P: Extensive vitiligo after ganciclovir treatment of GVHD in a patient who had received donor T cells expressing herpes simplex virus thymidine kinase. Lancet 2000;355:626–627.
Neumeister P, Strunk D, Apfelbeck U, Sill H, Linkesch W: Adoptive transfer of vitiligo after allogeneic bone marrow transplantation for non-Hodgkin’s lymphoma. Lancet 2000;355:1334–1335.
Au WY, Yeung CK, Chan HH, Lie AK: Generalized vitiligo after lymphocyte infusion for relapsed leukemia. Br J Dermatol 2001;145:1015–1017.
Alajlan A, Alfadley A, Pedersen KT: Transfer of vitiligo after allogeneic bone marrow transplantation. J Am Acad Dermatol 2002;46:606–610.
Cho SB, Roh MR, Chung KY, Lee KH, Park YK: Generalized vitiligo after allogeneic bone marrow transplantation. Acta Derm Venereol 2005;85:82–83.
Cathcart S, Marrell D: Vitiligo as a post-bone marrow transplantation complication. J Pediatr Hematol Oncol 2007;29:485–487.
Sherer Y, Shoenfeld Y: Autoimmune diseases and autoimmunity post-bone marrow transplantation. Bone Marrow Transplant 1998;22:873–881.
Johnson ML, Farmer ER: Graft-versus-host reactions in dermatology. J Am Acad Dermatol 1998;38:369–392.
Kawakami Y, Robbins PF, Wang RF, Parkhurst M, Kang X: The use of melanosomal proteins in the immunotherapy of melanoma. J Immunother Emphasis Tumour Immunol 1998;21:237–256.
Rouquette Gally AM, Boyeldieu D, Prost AC, Gluckman E: Autoimmunity after allogeneic bone marrow transplantation: a study of 53 long-term-surviving patients. Transplantation 1988;46:238–240.
Ferrara JLM, Deeg HJ: Graft-versus-host disease. N Engl J Med 1991;324:667–674.
Krasagakis K, Garbe C, Zouboulis CC, Orfanos CE: Growth control of melanoma cells and melanocytes by cytokines. Recent Results Cancer Res 1995;139:169–182.
Moretti S, Spallanzani A, Amato L, Hautmann G, Gallerani I, Fabiani M, Fabbri P: New insights into the pathogenesis of vitiligo: imbalance of epidermal cytokines at sites of lesions. Pigment Cell Res 2002;15:87–92.
Rigopoulos D, Gregoriou S, Larios G, Moustou E, Belayeva-Karatza E, Kalogeromitros D: Etanercept in the treatment of vitiligo. Dermatology 2007;215:84–85.
Seirafi H, Farnaghi F, Firooz A, Vasheghani-Farahani A, Alirezaie NS, Dowlati Y: Pimecrolimus cream in repigmentation of vitiligo. Dermatology 2007;214:253–259.
Göktay F, Mansur AT, Aydingöz IE: Colocalization of vitiligo and lichen planus on scrotal skin: a finding contrary to the actinic damage theory. Dermatology 2006;212:390–392.
Cavet J, Dickinson AM, Norden J, Taylor PR, Jackson GH, Middleton PG: Interferon-gamma and interleukin-6 gene polymorphisms associate with graft-versus-host disease in HLA-matched sibling bone marrow transplantation. Blood 2001;98:1594–1600.
Imamura M, Hashino S, Kobayashi H, Kubayashi S, Hirano S, Minagawa T, Tanaka J, Fujii Y, Kobayashi M, Kasai M, et al: Serum cytokine levels in bone marrow transplantation: synergistic interaction of interleukin-6, interferon-gamma, and tumor necrosis factor-alpha in graft-versus-host disease. Bone Marrow Transplant 1994;13:745–751.
Taştan B, Akar A, Orkunoğlu E, Arca E, İnal A: Association of HLA class 1 antigens and HLA class 2 alleles with vitiligo in a Turkish Population. Pigment Cell Res 2004;17:181–184.
Wyatt DT, Lum LG, Casper J, Hunter J, Camitta B: Autoimmune thyroiditis after bone marrow transplantation. Bone Marrow Transplant 1990;5:357–361.
Gardembas-Pain M, Ifrah N, Foussard C, Boasson M, Andre JPS, Verret JL: Psoriasis after allogeneic bone marrow transplantation (letter). Arch Dermatol 1990;126:1523.
Lampeter EF, Homberg M, Quabeck K, Schaefer UW, Wernet P, Bertrams J, Grosse-Wilde H, Gries FA, Kolb H: Transfer of insulin-dependent diabetes between HLA-identical siblings by bone marrow transplantation. Lancet 1993;341:1243–1244.
Waters AH, Metcalfe P, Minchinton RM, Barrett AJ, James DC: Autoimmune thrombocytopenia acquired from allogeneic bone marrow graft: compensated thrombocytopenia in bone marrow donor and recipient (letter). Lancet 1983;2:1430.
Remberger M, Kumlien G, Aschan J, Barkholt L, Hentschke P, Ljungman P, et al: Risk factors for moderate-to-severe chronic graft versus-host disease after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2002;8:674–682.
Fishman P, Merimski O, Baharav E, Shoenfeld Y: Autoantibodies to tyrosinase: the bridge between melanoma and vitiligo. Cancer 1997;79:1461–1464.
Bouloc A, Grange F, Delfau-Larue MH, Dieng MT, Tortel MC, Avril MF, Revuz J, Bagot M, Wechsler J: Leucoderma associated with flares of erythrodermic cutaneous T-cell lymphomas: four cases. The French Study Group of Cutaneous Lymphomas. Br J Dermatol 2000;143:832–836.
Fisher AA: Ask the experts: the differential diagnosis of contact leukoderma. Am J Contact Dermat 1997;8:52–55.
Kumar A, Freeman S: Leukoderma following occupational allergic contact dermatitis. Contact Dermatitis 1999;41:94–98.
Mimouni D, David M, Feinmesser M, Coire CI, Hodak E: Vitiligo-like leucoderma during photochemotherapy for mycosis fungoides. Br J Dermatol 2001;145:1008–1014.
Musette P, Bachelez H, Flageul B, Delarbre C, Kourilsky P, Dubertret L, Gachelin G: Immune-mediated destruction of melanocytes in halo nevi is associated with the local expansion of a limited number of T cell clones. J Immunol 1999;162:1789–1794.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.