Ewha Med J.  2017 Oct;40(4):155-158. 10.12771/emj.2017.40.4.155.

Halo Nevus Arising from Congenital Melanocytic Nevus Featuring an Early Onset Vitiligo

• Kwon O
• Choi Y
• Chung H
• Park J

• KMID: 2393719
• DOI: http://doi.org/10.12771/emj.2017.40.4.155

Abstract

Halo nevus and vitiligo are known to be associated with immunologic defect that result in typical skin lesions. Random shapes and sizes of whitish patches, depending on the type, are featured in vitiligo. Halo, on the other hand, presents by surrounding the previous pigmented lesion leaving a whitish-halo-like appearance. The mechanisms underlying these entities remain to be elucidated. Various immunological responses along with biomechanical activities suggest causal relationship between the two diseases. A 6-year-old male patient was recently presented with multiple whitish patches on the various parts of the body in a Koebner phenomenon manner. A noticeable hairy congenital melanocytic nevus surrounded a well-demarcated halo of depigmentation was also observed. Clinical and pathological findings were conclusive of as halo nevus with multiple concurrent vitiligo. The pathogenic relationship between the two entities must be underlined since the nature of disease progression is associated and the respective management may also be altered accordingly.

Keyword

Nevus, halo; Congenital mealnocytic nevus; Vitiligo

MeSH Terms

Child
Disease Progression
Hand
Humans
Male
Nevus, Halo*
Nevus, Pigmented*
Skin
Vitiligo*

Figure

• 

  Fig. 1 Clinical images at initial visit. (A) A 6 cm-sized patch with central pigmented hairy lesion surrounded by a whitish halo phenomenon on right neck. The whitish halo surrounding the congenital central lesion was developed 3 years in prior to visit. (B) Multiple variegated-shaped whitish patches on left periorbital area (arrows) where the corrective vision braces was in touch. Lesions had developed 1 year in prior to initial visit. (C) Multiple irregularly shaped whitish patches on posterior nape and upper back area (arrow heads). Lesions had developed 1 year in prior to initial visit. (D) Whitish patches around wound area of the right knee (right) and left knee (left). Lesions had developed 1 year in prior to initial visit.

• 

  Fig. 2 (A) Histopathological image from the central pigmented area of the right neck presenting heavy infiltration of nevus cells at the upper dermis (H&E, ×20). (B) Higher magnification reveals groups of nevus cluster with no definite atypia at the middle to lower dermis (H&E, ×100). (C) Skin biopsy was performed on the whitish surrounding and revealed significant reduction in melanocytes and melanin pigmentation (H&E, ×20). (D) Higher magnification revealed mild infiltration of the lymphocytes (H&E, ×100).

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