|THE CLINICAL PICTURE
|Year : 2021 | Volume
| Issue : 3 | Page : 193-194
Karan Sancheti1, Nidhi Gupta1, Anupam Das2, Piyush Kumar3
1 Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
2 Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
3 Departmentof Dermatology, Katihar Medical College, Katihar, Bihar, India
|Date of Submission||15-Jul-2020|
|Date of Decision||30-Nov-2020|
|Date of Acceptance||01-Mar-2021|
|Date of Web Publication||24-Nov-2021|
Dr. Anupam Das
Department of Dermatology, KPC Medical College and Hospital, Phoolbagan, Kolkata 700086, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sancheti K, Gupta N, Das A, Kumar P. Halo nevus. Pigment Int 2021;8:193-4
A 5-year-old boy presented with an area of depigmentation around a pre-existing hyperpigmented lesion on the trunk, present over the preceding 2 years. The lesion was asymptomatic and static. There was no significant history and other family members were not affected. Laboratory parameters such as complete blood cell count, blood urea serum creatinine, random blood sugar, and liver function test were within normal limits. General examination was unremarkable. On cutaneous examination, a central pigmented melanocytic nevus and a surrounding oval amelanotic annulus were observed [Figure 1]. There was no similar lesion elsewhere in the body. The hairs, nails, and mucosae were normal. The diagnosis of halo nevus was made clinically. Histopathologic examination from the center of the lesion showed nests of nevus cells embedded in a dense inflammatory infiltrate in the upper dermis and the diagnosis of halo nevus was confirmed [Figure 2]. No treatment was given other than reassurance.
|Figure 1 Central pigmented melanocytic nevus surrounded by an oval amelanotic annulus.|
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|Figure 2 Photomicrograph shows nests of nevus cells in the upper dermis surrounded by dense lymphocytic infiltrate (Hematoxylin and Eosin ×400).|
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Halo nevus synonymous with Sutton nevus represents the development of hypomelanosis in the form of a halo around a central cutaneous tumor which is usually an acquired melanocytic nevus but rarely can be congenital melanocytic nevus neurofibroma, dermatofibroma, blue nevus, malignant melanoma, or spitz nevus. It is observed in young adults and children of either sex commonly on trunk, limbs, and rarely face. Halo nevi most likely results from an immunologically mediated host response to a nevus and is accompanied by a dense inflammatory infiltrate with lymphocytes in a CD4:CD8 ratio varying from 1:1 to 1:3.. Rarely erythema may also be observed in a halo nevus due to dilatation of the dermal blood vessels, thickening of the vessel walls, and swelling of the endothelial cells. Poliosis has been recognized as a presenting sign of the halo phenomenon in the regressive stage of a melanocytic nevus. Return to normal appearing skin may occur but this involution takes an average of 7 years. No treatment is required usually. Melanoma is to be ruled out and surgery in case of melanoma is performed only after its histopathological confirmation. The excimer laser 308-nm may be an effective treatment of halo nevi.
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| References|| |
Rork JF, Hawryluk EB, Liang MG. Literature update on melanocytic nevi and pigmented lesions in the pediatric population. Curr Dermatol Rep. 2012;1:195-202.
Zeff RA, Freitag A, Grin CM, Grant-Kels JM. The immune response in halo nevi. J Am Acad Dermatol. 1997;37:620-4.
[Figure 1], [Figure 2]