To the Editor.—
The disparaging response of Drs James J. Nordlund and Aaron B. Lerner in the May Archives (115:636, 1979) to my letter in the October Archives (114:1551, 1978) fails to clarify their well-intentioned, but shaky, hypothesis from the April Archives (113:421, 1977). Their hypothesis is that "those factors that cause vitiligo may also destroy malignant pigment cells or at least retard their growth." The hypothesis draws inspiration from their impression that "the frequency of vitiligo increases with a prolongation of the interval between the excision of a primary melanoma and the appearance of metastatic lesions."There are indeed case reports in which regressions and apparent cures have occurred in patients with both malignant melanoma and vitiligo.1 However, Nordlund and Lerner admit the counterpoint, namely, the concurrence of vitiligo and metastases in patients whose primary malignant melanomas had been removed years before. Still, in their editorial, Nordlund and Lerner