Introduction
Halo dermatitis, also known as Meyerson's nevus characterized as an inflammatory, eczematous itchy skin eruption. Halo dermatitis usually encircles a preexisting melanocytic nevus, often misdiagnosed as malignant melanoma or Sutton's nevus. Halo dermatitis settles spontaneously within weeks and has no recurrence. Sutton's nevus is the common condition associated with halo dermatitis. However, the reasons for both diseases remain undefined. The co-occurrence of these disorders indicates common immunological mechanisms caused by pigment cells and their components.
What Is Halo Dermatitis?
In 1971 Meyerson first described the condition. As a result, halo dermatitis is also referred to as Meyerson naevus, halo eczema, and Meyerson's phenomenon. Halo dermatitis, or Meyerson naevus, is a mole surrounded by eczema characterized as an itchy rash, also known as dermatitis. A mole is more appropriately called a benign melanocytic naevus. Meyerson naevus appears more commonly in young males. It is highly susceptible in males compared to females. Meyerson naevi may occur in people with halo naevi and patients with eczema or other atopic conditions such as asthma and hay fever. However, it most frequently occurs in healthy people without any preexisting conditions.
What Are the Causes of Halo Dermatitis?
The exact etiology of halo dermatitis or Meyerson naevus is not known. However, skin biopsy specimens reveal inflamed skin, like psoriasis and eczema. It has been observed that it could result from allergic contact dermatitis, a hypersensitivity reaction, a response to sun exposure, or some medications. Halo dermatitis is immune-mediated by CD4 T lymphocytes as the significant cellular infiltrate. Excision of the central mole impacts the resolution of the eczematous reaction, which denotes the mole is the basis for it. It may result from immune cells such as CD4+ lymphocytes. CD4+ lymphocytes react against target antigens on the surface of the naevus cells called melanocytes. But it is observed that some of the factors will trigger the occurrence of halo dermatitis. Such triggering factors of halo dermatitis are mentioned below.
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Exposure to ultraviolet radiation.
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Severe sunburn.
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Interferon-alfa-2b.
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Behcet disease.
What Are the Symptoms of Halo Dermatitis?
Halo dermatitis or Meyerson naevus usually starts as a single itchy patch, but multiple continuous lesions have also been noted. Meyerson naevus has centrally positioned naevus with regular borders and uniform color. Centrally positioned, the naevus is surrounded by a red, dry, or blistering rash. Sometimes itching may or may not be present. The naevus or mole in the middle of the halo is rarely melanoma, a cancerous skin condition. The central naevus is the main differential feature between halo dermatitis and Sutton nevus. A Meyerson naevus's center lesion never disappears, even when surrounding eczema has settled. In contrast, the central mole fades in color and ultimately disappears in a halo mole completely.
Who Gets Meyerson Nevus?
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The skin disorder Meyerson Nevus, can affect adults and children.
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Males under 30 years old are more susceptible to Meyerson naevus. Compared to women, it occurs almost three times as frequently in men.
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Halo and Meyerson Naevi might coexist. Patients with eczema or other atopic illnesses (hay fever and asthma) may also experience it.
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But most of the time, healthy people with no underlying medical concerns experience it. In adults, the ratio of males to females is 3:1.
How to Diagnose Halo Dermatitis?
The diagnosis of halo dermatitis is made based on the symptoms and physical examination of the patient. Histopathology will support the differential diagnosis revealing a dense inflammatory infiltrate mainly produced by CD8 T lymphocytes. In severe form, halo dermatitis can be mistaken for malignant melanoma or Sutton's nevus. However, halo dermatitis is a benign inflammatory condition, and the symptoms of halo dermatitis will be resolved independently. The standard histological features of halo dermatitis are spongiosis with cellular infiltration made of lymphocytes and eosinophils. Other features include irregular acanthosis, parakeratosis, and an unchanged nevus. It is observed that the signs and symptoms of halo dermatitis resemble malignant melanoma and Sutton nevus. Some of the differential diagnosis of halo dermatitis are mentioned below.
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Malignant melanoma.
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Sutton nevus.
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Atypical nevi.
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Non-melanocytic lesions.
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Seborrheic keratosis.
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Dermatofibromas.
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Stucco keratosis.
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Lentigo.
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Keloid.
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Insect bites.
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Basal cell carcinoma.
Malignant Melanoma:
Melanoma is a tumor made by the malignant changeover of melanocytes. Melanocytes are derived from the neural crest. Consequently, melanomas occur on the skin and can appear in other locations, including the gastrointestinal tract and brain.
Sutton Naevus:
A Sutton naevus is a nevus around a white ring or halo. For example, the central dark brown naevus fades from dark brown to light brown to pink, eventually disappearing altogether. Other names of halo nevus are mentioned below.
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Halo melanocytic naevus
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Halo mole
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Regressing naevus
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Halo naevus.
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Leukoderma acquisitum centrifugum.
Eczema:
Eczema, also known as atopic dermatitis, is a skin inflammatory condition. Eczema is a chronic and pruritic skin inflammatory condition in infants. Eczema is more common between three to six months for babies, and such types of eczema are called infantile atopic dermatitis or baby eczema. Symptoms are commonly observed in the face, neck, head, elbows, and lower extremities. Patients with eczema will show elevated IgE antibodies. The common disorders associated with eczema are hay fever and other allergic conditions. Some herbal remedies will improve the symptoms of eczema.
What Is the Treatment for Halo Dermatitis?
Eczema around the Meyerson naevus usually resolves within weeks. It can be treated with topical corticosteroid cream or ointment. Because the naevus is benign, it requires no specific treatment. However, surgical excision may be done if there is any problem that the lesion is melanoma or because the symptoms are a disturbance. Malignant transformation is a problem with benign lesions presenting with inflammation. Halo dermatitis can resolve with excision or spontaneously within a few months without the involution of the nevi. The application of potent topical steroids will improve the symptoms.
Conclusion
Halo dermatitis, or Mayerson naevus, is a benign inflammatory condition characterized by eczematous skin itching. The exact etiology of the pathogenesis of halo dermatitis is unknown but is believed to be triggered by some predisposing factors. The clinical features are commonly observed in the trunk, and the diagnosis is made with standard histological features to avoid misdiagnosis. However, the symptoms of halo dermatitis will resolve independently, and topical corticosteroids can be applied to manage the symptoms.
