Vitiligo-like lesions in patients receiving anti–programmed cell death-1 therapies are distinct from spontaneously occurring active vitiligo

To the Editor: We would like to thank Fukuda and Harris for their interest in our manuscript.1 Clinically, we have voluntarily characterized vitiligo-like lesions induced by anti–programmed cell death-1 (PD-1) as "multiple flecked depigmented macules" to differ from the description reported for active lesions in spontaneously occurring vitiligo (referred to as vitiligo). Indeed, in vitiligo, active lesions are associated with hypomelanotic appearance and poorly defined borders2 (as shown in Fukuda et al, Fig 1), a clinical sign completely absent in vitiligo-like lesions under anti–PD-1.

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