Introduction:
Melanocytes are pigment-producing cells in the skin and hair follicles. Nevi are a collection of pigment-producing cells that are harmless. Melanocytic nevi are cancerous growth resulting from the proliferation of the normal pigment-producing cells in the skin. Many adults have nevi, but their abundance varies tremendously from individual to individual, ranging from a few nevi to hundreds of lesions per person. Compared with other clinically apparent, benign, but potentially precancerous lesions, melanocytic nevi are unique as they arise relatively early in life.
How Is Meyerson Nevus Otherwise Called?
It is also called,
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Meyerson's phenomenon.
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Halo dermatitis nevus.
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Halo eczema nevus.
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Spongiotic change in melanocytic nevi.
Who Gets Meyerson Nevus?
Meyerson nevus is commonly seen in young males with a 3:1 male-to-female ratio. Meyerson nevi are seen in healthy young adults' trunks and proximal extremities. Meyerson nevus may coexist with halo nevi. It may also occur in patients with dry, itchy skin, rashes, scaly patches, blisters, skin infections, or other allergic conditions like asthma and hay fever. However, it is commonly seen in healthy individuals without any pre-existing conditions. A pre-existing nevus may present with pruritus and scaling over the lesion. The eczematous halo is sharply defined and surrounds a central nevus symmetrically.
What Are the Variants of Meyerson Nevus?
Dermoscopy helps to observe colors and structures within melanocytic nevi. The dermoscopic diagnosis of nevi relies on four essential criteria: color, pattern, body site-specific pattern, and pigment distribution.
Color:
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Black or brown color due to melanin deposition either in keratinocytes or melanocytes.
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Gray color due to melanin deposition in keratinocytes, melanocytes, or melanophages.
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The blue color is either free or within melanocytes or melanophages due to melanin.
When the nevi are black, brown, and gray colors, the epidermal layer is involved, and a blue-colored nevus affects the dermal skin layer.
Pattern:
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Reticular network - Network of brownish interconnected lines over a diffuse pigmentation.
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Globular-cobblestone - Numerous, differently sized, large, closely aggregated, somehow angulated globule-like structures resembling brown and gray-black cobblestones.
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Starburst: They are bulbous, kinked fingerlike projections at the edge of a lesion seen as tan to black in color. They may rarely appear in the form of a network.
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Structureless blue - Structure-less blue pigmentation in the absence of a pigment network or other distinctive local features.
Location:
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Face - Pseudo network pattern intermingled by hairs.
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Acral - Parallel pigmented lines within the furrows or perpendicular to the furrows.
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Nail - Small pigmented band composed of parallel lines of uniform color and width.
Pigment Distribution:
Multifocal, central, eccentric, and uniform.
What Is the Cause of Meyerson Nevus?
The cause of Meyerson nevus is unknown, and its primary concern is malignant transformation. There is significant evidence that halo dermatitis is immune-mediated, where the CD4+ lymphocyte immune cells react against the target antigens on the nevus cell surface (these are melanocytes). Skin biopsy specimens reveal inflamed skin like in psoriasis and eczema.
Factors That Trigger Meyerson Nevus Are:
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Exposure to ultraviolet radiation.
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Interferon-alfa-2b therapy for HCV and Behcet's disease.
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Allergic contact dermatitis.
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Hypersensitivity reaction.
What Is the Clinical Presentation of Meyerson Nevus?
Meyerson nevus develops as a single itchy patch or multiple lesions appearing simultaneously. Meyerson nevus has a well-defined, erythematous scaly patch, uniform-colored centrally positioned nevus surrounded by a red, dry, or blistering rash. It may or may not be itchy. The naevus in the center of the halo is rarely cancerous (melanoma). Meyerson nevus mainly appears on the trunk or proximal extremities, although it can present on virtually any skin location. The Meyerson nevus pattern is blurred due to the overlying, yellowish serous crust. Once the eczematous reaction has resolved, the nevi return to their baseline dermoscopic morphology.
Meyerson nevus is sometimes confused with a halo mole (Sutton nevus). The distinguishing feature between the Meyerson nevus and Sutton nevus is that the center of a Meyerson nevus never fades away even when surrounding eczema has subsided. Still, in Sutton nevus, the center lags and disappears altogether.
How Is Meyerson Nevus Diagnosed?
The Following Methods Diagnose Meyerson Nevus:
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Evaluation of medical history and complete physical examination.
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Examining the lesion using dermoscopy.
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Perform wood lamp examination. In this, skin changes in pigmentation are examined under ultraviolet light.
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A skin biopsy is also done.
How Is the Meyerson Nevus Treated?
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Eczema surrounding the Meyerson nevus usually resolves by itself within weeks. However, when there is intense inflammation and itch, a topical corticosteroid cream or ointment is applied for a few days or weeks.
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The center of the nevus remains unchanged. As the naevus is harmless, there is no need for removal. Surgical excision is suggested if there is any chance of turning into melanoma or because the symptoms are a nuisance.
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When the Meyerson phenomenon overlies the malformation of the nuchal-occipital capillary, the lesion may be difficult to treat. In such cases, treating the malformation with a pulsed dye laser may resolve the lesion.
What Are the Other Lesions That Resemble Meyerson Nevus?
The other eczematous reactions that resemble Meyerson nevus are:
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Seborrheic keratoses.
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Squamous cell carcinomas.
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Dermatofibromas.
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Keloids.
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Congenital capillary malformations like port-wine stains.
What Are the Complications of Meyerson Nevus?
Meyerson nevus is a sporadic condition. The main complication of this condition is malignant transformation.
What Is the Prognosis of Meyerson Nevus?
The prognosis of Meyerson nevus is usually excellent with appropriate treatment, as they are generally benign lesions. Meyerson phenomenon resolves spontaneously or with mild local treatment of either topical steroids or minor surgical excision.
Conclusion:
Meyerson nevus is a rare benign entity. The main concern with this condition is malignant transformation. More patients and long follow-ups could help clarify the pathogenesis of Meyerson nevus and the association between the other lesions.