Pigmented Lesion with a Depigmented Rim
Am Fam Physician. 2017 Jul 1;96(1):53-54.
A 15-year-old girl presented with an asymptomatic pigmented mole that had been present for about 10 years. The mole had developed a white halo around it two years earlier. Over the past year, the halo enlarged, while the size and pigmentation of the mole decreased. She was in good health and was not taking any medications. There was no personal or family history of autoimmune disorders or melanoma.
Physical examination revealed a 4-mm, melanocytic nevus surrounded by a rim of depigmentation on the right scapula (Figure 1). No other cutaneous or systemic abnormalities were noted.
Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?
A. Blue nevus.
B. Halo nevus.
D. Nevus spilus.
E. Spitz nevus.
The answer is B: halo nevus. This is a benign lesion characterized by the appearance of a depigmented halo around a central melanocytic nevus. It is common in children and young adults, with a mean age at onset of 15 years, and it most often appears on the upper back.1 Over time, the central nevus may remain brown in color—the classic form of halo nevus (stage I)—or the pigment can disappear, leading to a pink-colored papule (stage II).2 The central nevus may eventually disappear, leading
REFERENCESshow all references
1. Price A, Polley D, Sabol ME, Elston DM. Dermpath quiz: an irregularly colored papule on the back of an adolescent female. Indian Dermatol Online J. 2015;6(suppl 1):S50–S52....
2. Huynh PM, Lazova R, Bolognia JL. Unusual halo nevi – darkening rather than lightening of the central nevus. Dermatology. 2001;202(4):324–327.
3. Patrizi A, Bentivogli M, Raone B, Dondi A, Tabanelli M, Neri I. Association of halo nevus/i and vitiligo in childhood: a retrospective observational study. J Eur Acad Dermatol Venereol. 2013;27(2):e148–e152.
4. Koga M, Koga K, Kiryu H, Nakayama J. Congenital Spitz nevus on the foot. J Dermatol. 2014;41(3):282–283.
This series is coordinated by John E. Delzell, Jr., MD, MSPH, Assistant Medical Editor.
A collection of Photo Quiz published in AFP is available at http://www.aafp.org/afp/photoquiz.
Previously published Photo Quizzes are now featured in a mobile app. Get more information at http:/www.aafp.org/afp/apps.
The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at http://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. E-mail submissions to firstname.lastname@example.org.
Copyright © 2017 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact email@example.com for copyright questions and/or permission requests.
Want to use this article elsewhere? Get Permissions