eczematous halo reaction in congenital pigmented nevus

© 2003

The International Society of Dermatology International Journal of Dermatology

2003,

42

, 895

895

Blackwell Publishing Ltd.Oxford, UKIJDInternational Journal of Dermatology0011-9059Blackwell Publishing Ltd, 200345

Morphology

XXXX

Vega

et al.

Eczematous halo reaction in congenital pigmented nevus

Jesús Vega,

MD

, Manuel Angel Rodríguez,

MD

, and Matilde Martínez,

MD

From the Department of Dermatology, Hospital de León, León, Spain

Correspondence

Jesús Vega Gutiérrez,

MD

C/Ferrari 5, 1

°

E 47001 Valladolid Spain E-mail: jvegagu@medynet.com

We describe a 2-year-old male child with no past family orpersonal history of interest (no allergies, atopic dermatitis,nummular eczema, or other remarkable cutaneous pathology).Since birth he presented with a mole on the internal side ofthe left knee. The lesion increased proportionally to thegrowth of the child, and at the moment of consultation itmeasured 1 cm in diameter. From the first year of age, somecases of pruritic papulosquamous eruption appeared aboveand surrounding the congenital pigmented nevi (Fig. 1).Diagnosis of halo dermatitis around the melanocytic nevusor Meyerson’s nevus was made. The patient’s poor responseto strong topical corticosteroid therapy and the troubles

occasioned to the patient’s parents made necessary the surgi-cal excision of the nevus.

Histopathologic study was compatible with Meyerson’snevus in congenital pigmented nevus: it showed nets of nevuscells at the dermo-epidermal junction and papillary and retic-ulary dermis, at times following the course of pilosebaceousfollicles. Besides these lesions, typical features of subacuteeczema could also be appreciated.

Meyerson’s nevus, also known as halo dermatitis, was firstdescribed in 1971 by Meyerson as an eczematiform reactionaround pre-existing nevi.

1

Reports of this eruption are sparseand only four children have been described with the lesion,from which two lesions appeared on a congenital pigmentednevus.

2–4

The treatment of choice is topical corticosteroids, althoughlesions frequently respond only partially to this treatment andflare again after a certain period of time.

3

In these cases, sur-gical removal of the nevus may be necessary in order to clearthe eczematous reaction, as in the case of our patient.

References

1 Meyerson LB. A peculiar papulosquamous eruption involving pigmented nevi.

Arch Dermatol

1971;

103

: 510–512.

2 Legoux B, Pawin H, Prigent F,

et al.

Naevus de Meyerson sur naevus pigmentaire congénital.

Ann Dermatol Venereol

1991;

118

: 873–874.3 Shifer O, Tchetchik R, Glazer O,

et al.

Halo dermatitis in children.

Pediatric Dermatol

1992;

9

: 275–277.4 Elenitsas R, Halpern AC. Eczematous halo reaction in

atypical nevi.

J Am Acad Dermatol

1996;

34

: 357–361.Figure 1 Papulosquamous eruption surrounding congenital pigmented nevus on the knee of a 2-year-old child