Association of giant congenital melanocytic nevus, halo nevus and vitiligo in a 75-year-old patient

Abstract

A giant congenital melanocytic nevus represents a rare condition. The halo phenomenon may be seen in congenital or acquired melanocytic nevi. In the literature, association of halo nevus and giant congenital melanocytic nevus is rare and the association of both with vitiligo even more rare. A 75-yearold woman at first consultation complained of a hyperchromic bluish-brown hairy macula on the lower back, buttocks and thighs present since birth and an achromic halo of onset three years ago. The histological features were consistent with congenital melanocytic nevus and halo nevus, respectively. After two years the patient developed achromic areas in normal skin, histologically consistent with vitiligo. The authors emphasize the rarity of this triple combination, the patient's age and the absence of malignant degeneration to date.

Congenital melanocytic nevi: Where are we now?

“…Pers, 20 as indicated by Moss,70 found that 53.9% of his patients with GCMN had significant psychological and social difficulties as a result of their lesions. In another study of 29 children with GCMN, 71 social problems were 187,[190][191][192][193] Halo nevi: reports 191,194 Smooth muscle hamartoma: reports 195 Shokeir syndrome: 1 report 196 CMN, Congenital melanocytic nevi.…”

Relevance of congenital melanocytic naevi in vitiligo

“…1,4 Several cases of CMN have been reported in combination with vitiligo and/or halo formation around the congenital naevus (HN-CMN). 3,[5][6][7][8][9] In the majority of these cases a halo formation around the congenital naevus precedes the onset of vitiligo, while a reverse or simultaneous order of appearance has also been described. 10 The association between vitiligo and halo naevi (not including HN-CMN) is much better established.…”

Spontaneous Involution of Congenital Melanocytic Nevus With Halo Phenomenon

“… 12 Most CMN cases with spontaneous regression and halo phenomenon are associated with development of vitiligo at a distant site. 4 – 6 , 11 Spontaneous regression of CMN without halo formation is a more exceptional case. 13 …”

“… 3 Spontaneous involution of CMN is a rare phenomenon, and it is often reported in association with halo phenomenon or vitiligo. 4 – 7 …”

“…The halo nevus or leukoderma acquisitum centrifugum, also called as Sutton nevus, is usually observed around congenital or acquired melanocytic nevi. 4 Halo phenomenon may also develop around Mongolian spot, café au lait macules, neurofibroma, basal cell carcinoma, seborrheic keratosis, histiocytoma, and flat warts. 8 The clinical manifestation of halo phenomenon is characterized by progressive lightening of the color, disappearance of central nevus afterwards, and persistence of hypopigmentation.…”