Objective:

To report a case of vitiligo-like depigmentation in a patient with early-stage triple-negative breast cancer receiving pembrolizumab-based therapy.

Approach:

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Key Findings:

• The patient developed vitiligo-like depigmentation during pembrolizumab maintenance therapy, primarily affecting the dorsal aspects of both hands and the perioral region.
• The depigmentation was asymptomatic and did not interrupt the planned course of immunotherapy.

Interpretation:

Vitiligo-like depigmentation may occur as a rare immune-related cutaneous manifestation in patients receiving pembrolizumab for early-stage TNBC, although its clinical significance remains unclear.

Limitations:

• The incidence and biological basis of immune-related depigmentation in breast cancer patients receiving immune checkpoint inhibitors are not well established.
• Further reports are needed to clarify the clinical significance of this manifestation.

Conclusion:

Recognizing vitiligo-like depigmentation may help clinicians differentiate it from other dermatological conditions and avoid unnecessary treatment interruptions.