{
  "abstract": "Introduction\n\nCDK4/6 inhibitors have revolutionized the therapeutic management of metastatic estrogen receptor-positive (ER+), HER2-negative breast cancer (BC) by increasing treatment efficacy while maintaining a favorable safety profile. An exceedingly rare adverse event associated with these agents is the development of vitiligo-like skin depigmentation.Objectives\n\nThis study aimed to characterize a case of ribociclib-induced vitiligo and investigate its underlying pathogenic mechanisms, with particular focus on vitiligo onset. We report the case of a 60-year-old postmenopausal female with metastatic, hormone-sensitive BC who experienced a durable partial remission during treatment with ribociclib in combination with aromatase inhibitors. During therapy, the patient developed hypopigmented lesions on her upper limbs 34 months after initiation of ribociclib, preceded by pruritus and erythema.Methods\n\nReflectance confocal microscopy (RCM) optical coherence tomography (OCT), and histopathological examination were used.Result\n\nRCM and OCT proved valuable for real-time assessment and monitoring of skin changes, thereby informing clinical decisions regarding the management of skin toxicity. The presence of an inflammatory infiltrate, comprising lymphocytes and hyper-reflective inflammatory cells, suggests that inhibition of the CDK4/6 pathway may enhance antitumor activity beyond cell cycle arrest by modulating the immune response and promoting immune-mediated tumor control.Conclusions\n\nThe observed alterations in melanocyte regression could represent evidence of systemic immune activation and autoimmunity influencing melanocyte viability. These mechanisms may have significant implications for improving patient prognosis.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiological, Oncological and Pathological Science, Sapienza University of Rome, Rome, Italy.",
    "Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, University of La Sapienza, Rome, Italy.",
    "Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.",
    "IDI-IRCCS Istituto Dermopatico dell'Immacolata, Rome, Italy."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Silvia Mezi"
    },
    {
      "affs": [
        1
      ],
      "name": "Flavia Persechino"
    },
    {
      "affs": [
        2
      ],
      "name": "Andrea Ascione"
    },
    {
      "affs": [
        0
      ],
      "name": "Antonella Chiavassa"
    },
    {
      "affs": [
        0
      ],
      "name": "Adele Artemi"
    },
    {
      "affs": [
        0
      ],
      "name": "Camilla Capasso"
    },
    {
      "affs": [
        1
      ],
      "name": "Simone Amato"
    },
    {
      "affs": [
        3
      ],
      "name": "Alessia Paganelli"
    },
    {
      "affs": [
        1
      ],
      "name": "Giovanni Pellacani"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f255km4mrwxvw.bib",
  "cited_by": 0,
  "doi": "10.5826/dpc.1603a6849",
  "fulltext_url": "https://europepmc.org/articles/PMC13557299",
  "id": "f255km4mrwxvw",
  "issns": [
    "2160-9381"
  ],
  "landing_url": "https://europepmc.org/article/MED/42858444",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2708|Chemotherapy-related skin toxicity"
    ]
  ],
  "openalex": "W7171978638",
  "pdf_url": "https://europepmc.org/articles/PMC13557299?pdf=render",
  "pmcid": "PMC13557299",
  "pmid": "42858444",
  "published": "2026-07-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/f255km4mrwxvw.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:18Z",
      "native_id": "MED:42858444",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42858444"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2708|Chemotherapy-related skin toxicity",
      "subfield": "general"
    }
  ],
  "title": "Ribociclib-Induced Vitiligo: A Case Report with Histological, Dermatoscopic, Confocal Microscopy, and LC-OCT Findings Along with a Narrative Literature Review.",
  "title_text": "Ribociclib-Induced Vitiligo: A Case Report with Histological, Dermatoscopic, Confocal Microscopy, and LC-OCT Findings Along with a Narrative Literature Review.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:18Z",
  "url": "https://research.draconitic.com/paper/f255km4mrwxvw",
  "venue": "Dermatology practical & conceptual",
  "versions": []
}