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Benign Neoplasms
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Abdullah Demirbaş, Ömer Faruk Elmas, Necmettin Akdeniz
Differential diagnosis: In patients who present with a halo nevus at an older age, melanoma of any location should be suspected. As compared with the symmetry found in the halo nevus, an asymmetric, irregular halo may be seen with melanoma, but asymmetry does not equate with malignancy. Melanoma is typified by other attributes such as generally >1 cm in size, irregular or notched borders, and marked color irregularity. Multiple halo nevi may be a sign of ocular or cutaneous melanoma elsewhere, particularly in older adults.
Childhood versus post-childhood vitiligo
Published in Electra Nicolaidou, Clio Dessinioti, Andreas D. Katsambas, Hypopigmentation, 2019
Electra Nicolaidou, Styliani Mastraftsi
A halo nevus (Figure 7.4), also termed Sutton's nevus, is a melanocytic nevus that is surrounded by a depigmented rim. The presence of halo nevi in children with vitiligo varies greatly among different countries and races: 2.5% in a study from Korea,8 7.2% in a Chinese study,12 18.4% in a study from France,26 and 26% in a study from the United States.27 An Italian study that included 27 children with halo nevi and vitiligo reported that in 11 children (40.7%), the appearance of halo nevi and vitiligo was almost simultaneous; in 9 children (33.3%), halo nevi preceded vitiligo; while in 7 children (25.9%), halo nevi followed the onset of vitiligo.28
The landscape of vitiligo in Latin America: a call to action
Published in Journal of Dermatological Treatment, 2023
Angela Londoño-Garcia, Andrea Arango Salgado, María de la Luz Orozco-Covarrubias, Angela Marie Jansen, Mariana Rico-Restrepo, María Cecilia Riviti, Margarita María Velásquez-Lopera, Carla Castro
The genetic and environmental causes of vitiligo are well-documented, but the underlying mechanisms are complex (8). Despite the lack of genetic investigations in LA, a positive family history of vitiligo was discovered in patients from Colombia (15%), Brazil (18%), and Mexico (26%) (8,15,16). Children with vitiligo in Mexico have a familial history among first- (73%) and second-degree relatives (27%) (17). A personal or familial history of autoimmune diseases is associated with more severe forms of vitiligo (18). Monozygotic twins had a concordance rate of only 23%, highlighting the influence of the environment on vitiligo development (19). Emotional stress is believed to be a trigger, but data remains limited (8). In a study of 701 Brazilian children, 67% of cases of vitiligo were induced by emotional causes (15). Physical trauma is also a trigger for vitiligo, as demonstrated by Koebner’s phenomenon, a sign of disease activity (8). Additionally, halo nevus is a risk factor for vitiligo (15,20). Low socioeconomic status may influence disease control, treatment adherence, QoL declines, and heightened stigmatization.
Vitiligo induced by immune checkpoint inhibitors in melanoma patients: an expert opinion
Published in Expert Opinion on Drug Safety, 2021
Janny E. Lommerts, Marcel W. Bekkenk, Rosalie M. Luiten
Patients with melanoma-associated vitiligo have a higher age at the onset of vitiligo and mostly have highly progressive skin depigmentations, which results in confetti-like depigmentation and hypochromic lesions (Figure 1(a)) [24,27,34]. Depigmentations can occur on the same predilections sites as non-segmental vitiligo (Figure 1(b)) and on sun-exposed areas (Figure 1(c)), such as the face, chest, and hands [31]. Furthermore, also leucotrichia (whitening of the hairs, Figure 1(d)) and halo nevi (depigmentations around benign melanocytic nevi) can be seen in melanoma-associated vitiligo (Figure 1) [24]. In rare cases, melanoma-associated vitiligo can be a symptom of Vogt–Koyanagi–Harada disease, i.e., autoimmune bilateral diffuse granulomatous uveitis associated with vitiligo, during or after ICI therapy [35]. Manifestation of vitiligo during ICI therapy occurs after a mean time of 9 months [31,36]. Similar to non-segmental vitiligo, depigmentations induced by ICI also show bilateral distributions. In some cases, depigmentations occur around the primary melanoma site or around cutaneous metastasis [37]. Depigmentations usually reside after discontinuation of ICI, although repigmentation can occur. Discrimination between melanoma-associated vitiligo and non-segmental vitiligo is challenging due to the lack of discriminative clinical and histological features [24,34]. Melanoma-associated vitiligo can also occur in melanoma patients before detection of melanoma and without treatment with ICI [25]. Since discrimination between the two types of vitiligo is difficult, a small percentage of these melanoma patients could be misdiagnosed as having normal vitiligo and later develop melanoma metastases due to late detection of the primary melanoma.
Management of resistant halo nevi
Published in Journal of Cosmetic and Laser Therapy, 2019
Sherif S Awad, Rasha TA Abdel Aziz, Sahar S Mohammed
Halo nevus (HN), also termed leukoderma acquisitum centrifugum or Sutton’s nevus, is usually a benign pigmented melanocytic nevus surrounded by a depigmented ring (1,2). It has an incidence of 1% in the general population. The mean age of onset is 15 years, and it occurs equally in males and females. The nevus itself is most commonly acquired, but rarely develops around congenital nevi. Patients may have one or multiple halo nevi, and the most common location is on the trunk.