PMID- 14618342
OWN - NLM
STAT- MEDLINE
DCOM- 20040226
LR  - 20181113
IS  - 0721-832X (Print)
IS  - 0721-832X (Linking)
VI  - 241
IP  - 12
DP  - 2003 Dec
TI  - Vogt-Koyanagi-Harada syndrome associated with cutaneous malignant melanoma: an 
      11-year follow-up.
PG  - 996-9
AB  - PURPOSE: To report a case of Vogt-Koyanagi-Harada (VKH) syndrome associated with 
      cutaneous pigmented malignant melanoma (MM) and non-pigmented nodular metastasis 
      after a 10-year recurrence-free interval. METHODS: Case report with long-term 
      follow-up of 11 years. Ocular examinations included best-corrected visual acuity 
      (ETDRS charts), fundus photography, fluorescein angiography, and 
      computer-assisted perimetry. In addition, human leukocyte antigen (HLA) typing 
      was performed. RESULTS: A 48-year-old white female patient developed VKH disease 
      5 years after she had undergone surgical treatment of a superficial spreading 
      melanoma on her back in 1991. The first symptoms were diffuse alopecia followed 
      by growth of non-pigmented hair after 8 months. In our clinic, she presented 18 
      months later with cells and opacification in the vitreous, a macular and optic 
      disc edema and atrophy of the retinal pigment epithelium (RPE). The anterior 
      segment showed endothelial precipitates of the cornea, and a progressive 
      secondary cataract. Fluorescein angiography detected a bilateral edema of the 
      macula and the optic disc, and focal leakage in the RPE level. During follow-up 
      the patient developed more cutaneous signs, such as vitiligo-like depigmentation 
      and poliosis. A non-pigmented lymph node MM metastasis was diagnosed after a 
      10-year disease-free interval. HLA typing was positive for HLA-A*01, HLA-A*24, 
      HLA-B*08, HLA-B*39, HLA-DRB1*03, and HLADRB1*11. CONCLUSION: Our findings suggest 
      that the described ocular findings of VKH disease may represent a component of a 
      syndrome consisting also of melanoma-associated hypopigmentation. Within the 
      framework of current concepts of immunity in patients with MM and VKH, the long 
      recurrence-free interval might support the hypothesis of an autoimmune or 
      hypersensitivity process against melanocytes. The use of immunosuppressive 
      therapy in the treatment of VKH and its potential influence on the development of 
      metastatic disease should be carefully reconsidered.
FAU - Aisenbrey, Sabine
AU  - Aisenbrey S
AD  - Center of Ophthalmology, University of Cologne, Joseph-Stelzmann-Strasse 9, 50931 
      Cologne, Germany. s.aisenbrey@web.de
FAU - Luke, Christoph
AU  - Luke C
FAU - Ayertey, Helen D
AU  - Ayertey HD
FAU - Grisanti, Salvatore
AU  - Grisanti S
FAU - Perniok, Andreas
AU  - Perniok A
FAU - Brunner, Richard
AU  - Brunner R
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20031114
PL  - Germany
TA  - Graefes Arch Clin Exp Ophthalmol
JT  - Graefe's archive for clinical and experimental ophthalmology = Albrecht von 
      Graefes Archiv fur klinische und experimentelle Ophthalmologie
JID - 8205248
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Female
MH  - Fluorescein Angiography
MH  - Follow-Up Studies
MH  - HLA Antigens/analysis
MH  - Humans
MH  - Lymphatic Metastasis
MH  - Melanoma/*complications
MH  - Middle Aged
MH  - Skin Neoplasms/*complications
MH  - Uveomeningoencephalitic Syndrome/*etiology
MH  - Visual Acuity
MH  - Visual Field Tests
EDAT- 2003/11/18 05:00
MHDA- 2004/02/27 05:00
CRDT- 2003/11/18 05:00
PHST- 2003/03/11 00:00 [received]
PHST- 2003/09/02 00:00 [revised]
PHST- 2003/09/03 00:00 [accepted]
PHST- 2003/11/18 05:00 [pubmed]
PHST- 2004/02/27 05:00 [medline]
PHST- 2003/11/18 05:00 [entrez]
AID - 10.1007/s00417-003-0787-5 [doi]
PST - ppublish
SO  - Graefes Arch Clin Exp Ophthalmol. 2003 Dec;241(12):996-9. doi: 
      10.1007/s00417-003-0787-5. Epub 2003 Nov 14.