{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:55:20Z","timestamp":1790286920437,"version":"4.1.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vitiligo-like leucoderma is a rare cutaneous adverse event associated with cyclin-dependent kinases 4 and 6 (CDK4\/6) inhibitors. However, its clinicopathological and immunohistochemical profiles remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize the clinical, pathological and immunohistochemical features of CDK4\/6 inhibitor-induced vitiligo-like leucoderma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective case series describes five female patients with advanced or metastatic breast cancer who developed vitiligo-like leucoderma during CDK4\/6 inhibitor therapy. Clinical data and skin biopsies were evaluated, including immunohistochemical analysis of melanocyte markers, cell-cycle protein (p16) and T-cell subsets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The depigmented lesions appeared primarily in sun-exposed areas. Two patients exhibited an inflammatory phenotype with pruritus and a lichenoid rash. In all patients, the lesions progressed rapidly over several months and then stabilized. This course was maintained regardless of any vitiligo-targeted therapeutic interventions. Histopathological examination revealed complete absence of melanocytes in all biopsies. Three specimens (60%) had inflammatory changes, including lichenoid and perivascular lymphohistiocytic infiltrates, with immunohistochemistry showing a predominance of CD4+ T cells within the infiltrates. Features of chronic actinic damage (epidermal atrophy, orthokeratosis, reactive keratinocytes, dermal solar elastosis) were observed. In two biopsies (40%), there was a patchy distribution of p16 staining within basal and suprabasal keratinocytes. Four patients (80%) demonstrated prolonged (2\u20134\u2005years) progression-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CDK4\/6 inhibitor-induced vitiligo-like leucoderma appears to be a distinct clinicopathological entity, characterized by a predictable course and stabilization, consistent inflammatory features, and a CD4-predominant immune profile. These findings suggest a unique pathogenic mechanism, either immune-mediated or associated with actinic damage, that distinguishes this condition from classic vitiligo and immune checkpoint inhibitor-induced vitiligo-like leucoderma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ced\/llaf482","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T13:13:29Z","timestamp":1761830009000},"page":"427-434","source":"Crossref","is-referenced-by-count":2,"title":["Vitiligo-like leucoderma following treatment with cyclin-dependent kinase 4 and 6 inhibitors: analysis of clinicopathological and immunohistochemical findings"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5998-0621","authenticated-orcid":false,"given":"Maya","family":"Engler Markowitz","sequence":"first","affiliation":[{"name":"Division of Dermatology, Rabin Medical Center \u2013 Beilinson Hospital , Petach Tikva ,","place":["Israel"]},{"name":"Gray 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,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Science, Tel Aviv University , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aviv","family":"Barzilai","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Science, Tel Aviv University , Tel Aviv ,","place":["Israel"]},{"name":"Department of Dermatology, Sheba Medical Center , Tel Hashomer ,","place":["Israel"]},{"name":"Institute of Pathology, Sheba Medical Center , Tel Hashomer ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einav","family":"Nili Gal-Yam","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Science, Tel Aviv University , Tel Aviv ,","place":["Israel"]},{"name":"Breast Oncology Institute, Sheba Medical Center , Tel Hashomer 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Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mimouni","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Rabin Medical Center \u2013 Beilinson Hospital , Petach Tikva ,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Science, Tel Aviv University , Tel Aviv ,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2323-3512","authenticated-orcid":false,"given":"Shany","family":"Sherman","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Rabin Medical Center \u2013 Beilinson Hospital , Petach Tikva ,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Science, Tel Aviv University , Tel Aviv 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