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Background: Clinical factors associated with vitiligo in patients receiving antieprogrammed cell death-1 (PD-1) remain unknown.Objective: To better characterize the occurrence of vitiligo in patients receiving antiePD-1. Methods:The present single-center ambispective cohort study included patients with melanoma treated with antiePD-1. Progression-free survival, overall survival, and objective tumor response were compared between patients with and those without vitiligo using Kaplan-Meier curves and the log-rank test. Demographic and clinical factors associated with vitiligo were evaluated using multivariate logistic regression.Results: Of the 457 patients included in the study, vitiligo developed in 85 patients. The clinical presentation of vitiligo consisted of the presence of ovalar and multiple flecked white macules, mainly located on chronic sun-exposed areas. The presence of vitiligo was associated with a significant improvement in overall survival and progression-free survival (P \ .001). A Cox proportional hazards model estimation demonstrated markedly improved survival in patients with vitiligo compared with those without vitiligo (aHR [overall survival], 0.20; 95% CI, 0.12-0.33; P \ .001; and aHR [progression-free survival], 0.33; 95% CI, 0.23-0.47; P \.001). In the multivariate logistic regression analyses, men showed an independent increased risk of the development of vitiligo (odds ratio, 1.66). In contrast, the presence of pulmonary metastases was found to be an independent factor associated with a reduced risk of the development of vitiligo (odds ratio, 0.50).Limitations: Single-center ambispective cohort. Conclusion:Vitiligo in patients receiving antiePD-1 for advanced melanoma is associated with a better outcome. A gender effect associated with the development of vitiligo will need further investigation. ( JAAD Int 2021;5:112-20.)

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