Korean J Dermatol.  2020 Jan;58(1):39-42.

Multiple Actinic Keratoses within Vitiliginous Patches in a Patient with Non-segmental Vitiligo

Affiliations
  • 1Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
  • 3Department of Pathology, Yonsei University College of Medicine, Korea
  • 4Korea Institute of Vitiligo Research and Drs. Woo and Hann's Skin Center, Seoul, Korea

Abstract

A 74-year-old man visited our department with complaints of multiple asymptomatic erythematous scaly crusted patches on the scalp. He had non-segmental vitiligo with the extent of over 20% of the body surface area for 30 years. Biopsies showed hyperkeratosis, foci of atypical, pleomorphic keratinocytes along the basal cell layer, and marked solar elastosis, consistent with actinic keratosis (AK). Melan-A and Fontana-Masson staining showed absence of melanin and melanocytes. Despite conflicting data on the prevalence of skin cancers in patients with vitiligo, it is known that vitiligo does not increase nor decrease the risk of skin cancer. Recent studies have reported that patients with vitiligo lesions show increased epidermal expression of wild-type p53 protein than healthy controls. However, a few cases of skin cancer have been reported in patients with vitiligo. Here, we report a case of AK developing in vitiligo lesions. Dermatologists should not overlook the possible occurrence of AK or skin cancers in sun-exposed vitiliginous skin.

Keyword

Actinic keratosis; Skin cancer; Vitiligo; UV
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