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Halo Nevi in the Pediatric Population. JOURNAL OF THE DERMATOLOGY NURSES' ASSOCIATION 2023. [DOI: 10.1097/jdn.0000000000000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Nedelcu R, Dobre A, Brinzea A, Hulea I, Andrei R, Zurac S, Balaban M, Antohe M, Manea L, Calinescu A, Coman A, Pantelimon F, Dobritoiu A, Popescu C, Popescu R, Balasescu E, Ion D, Turcu G. Current Challenges in Deciphering Sutton Nevi-Literature Review and Personal Experience. J Pers Med 2021; 11:jpm11090904. [PMID: 34575681 PMCID: PMC8470687 DOI: 10.3390/jpm11090904] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 01/01/2023] Open
Abstract
Halo nevi, known as leukoderma acquisitum centrifugum, Sutton nevus, leukopigmentary nevus, perinevoid vitiligo, or perinevoid leukoderma, together with vitiligo and melanoma-associated hypopigmentation, belong to the group of dermatoses designated as immunological leukodermas. The etiology and pathogenesis of halo nevi has not been fully elucidated. There are several mechanisms through which a lymphocytic infiltrate can induce tumoral regression. In this review, we aimed to update the knowledge about Sutton nevi starting with the clinical appearance and dermoscopic features, continuing with information regarding conventional microscopy, immunohistochemistry, and the immunological mechanisms responsible for the occurrence of halo nevi. We also included in the article original unpublished results when discussing dermoscopic, pathologic and immunohistochemical results in halo nevi. Sutton nevi are valuable models for studying antitumor reactions that the human body can generate. The slow and effective mechanism against a melanocytic skin tumor can teach us important lessons about both autoimmune diseases and anticancer defenses.
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Affiliation(s)
- Roxana Nedelcu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Alexandra Dobre
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Correspondence: ; Tel.: +40-740-853-353
| | - Alice Brinzea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
- National Institute for Infectious Diseases, Outpatient Clinic, 021105 Bucharest, Romania
| | - Ionela Hulea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Razvan Andrei
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
- Synevo Medical Laboratory, 014192 Bucharest, Romania
| | - Sabina Zurac
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Mihaela Balaban
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Mihaela Antohe
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Lorena Manea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
- Department of Dermatovenerology, Centre Hospitalier Régional D’orléans, 45100 Orléans, France
| | - Andreea Calinescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Anastasia Coman
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | | | - Adina Dobritoiu
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Catalin Popescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Raluca Popescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Elena Balasescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Daniela Ion
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Gabriela Turcu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
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Birkenfeld JS, Tucker-Schwartz JM, Soenksen LR, Avilés-Izquierdo JA, Marti-Fuster B. Computer-aided classification of suspicious pigmented lesions using wide-field images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 195:105631. [PMID: 32652382 DOI: 10.1016/j.cmpb.2020.105631] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Early identification of melanoma is conducted through whole-body visual examinations to detect suspicious pigmented lesions, a situation that fluctuates in accuracy depending on the experience and time of the examiner. Computer-aided diagnosis tools for skin lesions are typically trained using pre-selected single-lesion images, taken under controlled conditions, which limits their use in wide-field scenes. Here, we propose a computer-aided classifier system with such input conditions to aid in the rapid identification of suspicious pigmented lesions at the primary care level. METHODS 133 patients with a multitude of skin lesions were recruited for this study. All lesions were examined by a board-certified dermatologist and classified into "suspicious" and "non-suspicious". A new clinical database was acquired and created by taking Wide-Field images of all major body parts with a consumer-grade camera under natural illumination condition and with a consistent source of image variability. 3-8 images were acquired per patient on different sites of the body, and a total of 1759 pigmented lesions were extracted. A machine learning classifier was optimized and build into a computer aided classification system to binary classify each lesion using a suspiciousness score. RESULTS In a testing set, our computer-aided classification system achieved a sensitivity of 100% for suspicious pigmented lesions that were later confirmed by dermoscopy examination ("SPL_A") and 83.2% for suspicious pigmented lesions that were not confirmed after examination ("SPL_B"). Sensitivity for non-suspicious lesions was 72.1%, and accuracy was 75.9%. With these results we defined a suspiciousness score that is aligned with common macro-screening (naked eye) practices. CONCLUSIONS This work demonstrates that wide-field photography combined with computer-aided classification systems can distinguish suspicious from non-suspicious pigmented lesions, and might be effective to assess the severity of a suspicious pigmented lesions. We believe this approach could be useful to support skin screenings at a population-level.
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Affiliation(s)
- Judith S Birkenfeld
- Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA; MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave., Cambridge, MA 02139, USA; Brigham and Women's Hospital - Harvard Medical School, 75 Francis St, Boston, MA 02115, United States; Massachusetts General Hospital - Harvard Medical School, 55 Fruit St, Boston, MA 02114, United States.
| | - Jason M Tucker-Schwartz
- MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave., Cambridge, MA 02139, USA
| | - Luis R Soenksen
- Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA; MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave., Cambridge, MA 02139, USA; Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA; Wyss Institute for Biologically Inspired Engineering, Harvard University, 3 Blackfan Cir, Boston, MA 02115, USA; Harvard-MIT Program in Health Sciences and Technology, Cambridge, MA 02139, USA
| | - José A Avilés-Izquierdo
- Department of Dermatology, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Berta Marti-Fuster
- Research Laboratory of Electronics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA; MIT linQ, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 77 Massachusetts Ave., Cambridge, MA 02139, USA; Brigham and Women's Hospital - Harvard Medical School, 75 Francis St, Boston, MA 02115, United States
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Bellei B, Picardo M. Premature cell senescence in human skin: Dual face in chronic acquired pigmentary disorders. Ageing Res Rev 2020; 57:100981. [PMID: 31733332 DOI: 10.1016/j.arr.2019.100981] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/16/2019] [Accepted: 11/07/2019] [Indexed: 01/10/2023]
Abstract
Although senescence was originally described as an in vitro acquired cellular characteristic, it was recently recognized that senescence is physiologically and pathologically involved in aging and age-related diseases in vivo. The definition of cellular senescence has expanded to include the growth arrest caused by various cellular stresses, including DNA damage, inadequate mitochondria function, activated oncogene or tumor suppressor genes and oxidative stress. While senescence in normal aging involves various tissues over time and contributes to a decline in tissue function even with healthy aging, disease-induced premature senescence may be restricted to one or a few organs triggering a prolonged and more intense rate of accumulation of senescent cells than in normal aging. Organ-specific high senescence rate could lead to chronic diseases, especially in post-mitotic rich tissue. Recently, two opposite acquired pathological conditions related to skin pigmentation were described to be associated with premature senescence: vitiligo and melasma. In both cases, it was demonstrated that pathological dysfunctions are not restricted to melanocytes, the cell type responsible for melanin production and transport to surrounding keratinocytes. Similar to physiological melanogenesis, dermal and epidermal cells contribute directly and indirectly to deregulate skin pigmentation as a result of complex intercellular communication. Thus, despite senescence usually being reported as a uniform phenotype sharing the expression of characteristic markers, skin senescence involving mainly the dermal compartment and its paracrine function could be associated with the disappearance of melanocytes in vitiligo lesions and with the exacerbated activity of melanocytes in the hyperpigmentation spots of melasma. This suggests that the difference may arise in melanocyte intrinsic differences and/or in highly defined microenvironment peculiarities poorly explored at the current state of the art. A similar dualistic phenotype has been attributed to intratumoral stromal cells as cancer-associated fibroblasts presenting a senescent-like phenotype which influence the behavior of neoplastic cells in either a tumor-promoting or tumor-inhibiting manner. Here, we present a framework dissecting senescent-related molecular alterations shared by vitiligo and melasma patients and we also discuss disease-specific differences representing new challenges for treatment.
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Affiliation(s)
- Barbara Bellei
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy.
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology and Integrated Center for Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
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Melanoma and Vitiligo: In Good Company. Int J Mol Sci 2019; 20:ijms20225731. [PMID: 31731645 PMCID: PMC6888090 DOI: 10.3390/ijms20225731] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/10/2019] [Accepted: 11/13/2019] [Indexed: 12/24/2022] Open
Abstract
Cutaneous melanoma represents the most aggressive form of skin cancer, whereas vitiligo is an autoimmune disorder that leads to progressive destruction of skin melanocytes. However, vitiligo has been associated with cutaneous melanoma since the 1970s. Most of the antigens recognized by the immune system are expressed by both melanoma cells and normal melanocytes, explaining why the autoimmune response against melanocytes that led to vitiligo could be also present in melanoma patients. Leukoderma has been also observed as a side effect of melanoma immunotherapy and has always been associated with a favorable prognosis. In this review, we discuss several characteristics of the immune system responses shared by melanoma and vitiligo patients, as well as the significance of occurrence of leukoderma during immunotherapy, with special attention to check-point inhibitors.
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Abstract
Vitiligo is a common acquired depigmenting skin disease characterized by a progressive loss of functional melanocytes. It may appear from the first years of life to late adulthood. Childhood vitiligo (CV), defined as vitiligo that begins before the age of 12 years, is common and may differ from post-CV in terms of epidemiology, clinical presentation, comorbidities, and treatment options. Taking into consideration the potential significant psychosocial impact of the disease on both children and their parents, all available therapeutic options must be offered to patients who desire treatment. According to the most recent guidelines, topical corticosteroids, topical calcineurin inhibitors, and narrowband ultraviolet B phototherapy are the most commonly used treatment modalities for vitiligo in children. This review presents recent data regarding the whole spectrum of CV. Differences between CV and post-CV are also discussed.
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Affiliation(s)
- Electra Nicolaidou
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens School of Medicine, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Styliani Mastraftsi
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens School of Medicine, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece.
| | - Vassiliki Tzanetakou
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens School of Medicine, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Dimitrios Rigopoulos
- First Department of Dermatology and Venereology, National and Kapodistrian University of Athens School of Medicine, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
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Affiliation(s)
- Taylor Dodgen
- Correspondence to: Taylor Dodgen, MD, Metrohealth Medical Center/Case Western Reserve University, 2500 Metrohealth Drive Suite H576, Cleveland, OH 44109.
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Zhou H, Wu LC, Chen MK, Liao QM, Mao RX, Han JD. Factors Associated with Development of Vitiligo in Patients with Halo Nevus. Chin Med J (Engl) 2018; 130:2703-2708. [PMID: 29133759 PMCID: PMC5695056 DOI: 10.4103/0366-6999.218011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Halo nevus (HN) has been shown to be associated with vitiligo, but no standard signs are currently available to identify HN patients at risk of vitiligo, and the relevant data obtained in previous studies are somewhat conflicting. This study aimed to identify factors affecting the presence of vitiligo in HN patients. Methods: We performed a retrospective study on consecutive patients with HN at the First Affiliated Hospital of Sun Yat-sen University between January 2011 and December 2016. Detailed demographic and clinical data were collected to identify the factors associated with the presence of vitiligo in this cohort of patients using uni- and multi-variate logistic regression analyses. Results: A total of 212 HN patients were included, 101 of whom had vitiligo-associated HN (HNV). Univariate analysis indicated that a personal history of thyroid diseases was positively associated with HNV (odds ratio [OR] = 10.761, P = 0.025), while the onset age of HN was negatively associated with HNV (OR = 0.537, P = 0.026). Multivariate analysis demonstrated that the Koebner phenomenon (KP; OR = 10.632, P < 0.0001), multiple HN (OR = 3.918, P < 0.0001), and a familial history of vitiligo (OR = 3.222, P = 0.014) were independent factors associated with HNV. Conclusions: HN without vitiligo has clinical features distinct from HN associated with vitiligo. HN patients with KP, multiple lesions, or familial history of vitiligo are more likely to develop vitiligo and therefore should be monitored for clinical signs of such accompanied conditions.
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Affiliation(s)
- Hui Zhou
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Liang-Cai Wu
- Department of Dermatology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510650, China
| | - Mu-Kai Chen
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Qi-Man Liao
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Ren-Xiang Mao
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jian-De Han
- Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
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Abstract
BACKGROUND Halo nevus (HN) is a rare dermatologic disorder characterized by typical whitish rim surrounding an existing melanocytic nevus resembling halo. It is a cosmetic problem that may be linked to vitiligo, and it is advised to remove these nevi in order to avoid development of vitiligo. OBJECTIVES The aim of the present study is to evaluate the cosmetic outcome after nevus removal and leukoderma dermabrasion with epithelial graft followed by narrow-band ultraviolet B (NB-UVB) phototherapy as management of resistant halo nevi and avoidance of development of vitiligo. PATIENTS AND METHODS Ten patients with persisting halo nevi were selected as candidates in this study. Superficial dermabrasion was carried out using proper diamond fraises on depigmented rim and then punch biopsy probes with suitable size were used to harvest the nevus. Thiersch graft was prepared and applied on the dermabraded depigmented area. After 1 week of the procedure, patients were exposed to NB-UVB twice weekly and were followed up for 3 months. RESULTS Repigmentation was noticed in 2 weeks and was nearly fully accomplished in all 10 patients within the 3-month period. No other vitiligo lesions developed during this period in all patients except for one case. CONCLUSION Excision of Sutton's nevus with combined dermabrasion and Thiersch grafting followed by phototherapy is a good aesthetic maneuver in treating halo nevi and helps in avoiding further vitiligo depigmentation.
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Affiliation(s)
- Sherif S Awad
- a Department of Dermatology and Venereology, Faculty of Medicine , Minia University , Minia , Egypt
| | - Rasha Ta Abdel Aziz
- a Department of Dermatology and Venereology, Faculty of Medicine , Minia University , Minia , Egypt
| | - Sahar S Mohammed
- a Department of Dermatology and Venereology, Faculty of Medicine , Minia University , Minia , Egypt
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Prevalence of choroidal nevus and retinal pigment epithelial alterations in vitiligo patients. Graefes Arch Clin Exp Ophthalmol 2018; 256:927-933. [PMID: 29549426 DOI: 10.1007/s00417-018-3958-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/27/2018] [Accepted: 03/07/2018] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To investigate ocular manifestations in patients with vitiligo by multimodal imaging, including optical coherence tomography (OCT), color fundus photography, and fundus autofluorescence (FAF). METHODS In this prospective, observational clinical study, vitiligo patients underwent ophthalmologic and dermatologic clinical assessment and imaging by spectral-domain OCT, FAF, and color fundus imaging. Ocular echography was performed as indicated. Statistical analysis was performed using paired T test and Pearson correlation. RESULTS A total of 61 eyes of 31 vitiligo patients were examined. Ocular findings consisted of choroidal nevi (n = 10, 32%), of which four (40%) were bilateral; two patients (6.5%) had a prominent choroidal pattern, two (6.5%) had hypopigmentary retinal pigment epithelium (RPE) lesions, and one (3.2%) had peripapillary atrophy of the RPE. Choroidal nevi were demonstrated only in eyes of patients with generalized vitiligo and were more common with upper body involvement (p = 0.02) and more prevalent in women (p = 0.02). Hypopigmentary lesions were detected in two patients and demonstrated on OCT as RPE atrophy and as photoreceptor/RPE changes. CONCLUSIONS In this case series, vitiligo patients had a higher rate of choroidal nevi than previously reported. The hypopigmentary vitiliginous fundus lesions were depicted on OCT as photoreceptor and RPE atrophy. These findings may suggest the advisability of regular ocular monitoring for vitiligo patients.
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Cohen BE, Mu EW, Orlow SJ. Comparison of Childhood Vitiligo Presenting with or without Associated Halo Nevi. Pediatr Dermatol 2016; 33:44-8. [PMID: 26573093 DOI: 10.1111/pde.12717] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous studies have characterized differences in vitiligo associated with halo nevi, but the features of vitiligo presenting with halo nevus in children have yet to be fully described. AIMS We sought to provide an epidemiologic and clinical comparison of cases of childhood vitiligo presenting with or without associated halo nevi. MATERIALS AND METHODS This was a retrospective chart review of children diagnosed with vitiligo in an academic pediatric dermatology practice from January 1990 to November 2014. The characteristics of children with vitiligo with or without associated halo nevi were compared. RESULTS Halo nevi were identified in 55 (26%) of 208 children with vitiligo. Patients with halo nevi were significantly more likely to be male and develop vitiligo at a later age. Children with vitiligo associated with halo nevi were more likely to present with generalized vitiligo, defined according to the presence of bilateral macules. DISCUSSION There was no significant association between groups in the percentage of body surface area with vitiligo or family history of vitiligo or autoimmune diseases. Patients with halo nevi were no more likely to develop new areas of vitiligo during the follow-up period, but there was a nonsignificant trend toward a higher rate of repigmentation in vitiligo associated with halo nevus. CONCLUSION Halo nevi are a common finding in children with vitiligo. The presence of a halo nevus in a child with vitiligo is associated with generalized vitiligo. The presence of a halo nevus does not significantly alter the risk of disease progression and rate of treatment.
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Affiliation(s)
- Brandon E Cohen
- Ronald O. Perelman Department of Dermatology, School of Medicine, New York University, New York, New York
| | - Euphemia W Mu
- Ronald O. Perelman Department of Dermatology, School of Medicine, New York University, New York, New York
| | - Seth J Orlow
- Ronald O. Perelman Department of Dermatology, School of Medicine, New York University, New York, New York
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Dermoscopy of halo nevus in own observation. Postepy Dermatol Alergol 2014; 31:152-8. [PMID: 25097486 PMCID: PMC4112264 DOI: 10.5114/pdia.2014.40963] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 12/22/2013] [Accepted: 01/02/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction Halo nevus (HN) is a rare dermatologic entity characterized by a typical whitish rim encircling the existing melanocytic nevus resembling a halo. The clinical picture is suggesting its diagnosis, but so far only several dermoscopic descriptions of halo nevus have existed in the PubMed database. Aim To present the clinical and dermoscopic characteristics of halo nevus observed in dermoscopy. Material and methods Fifteen patients were diagnosed clinically and dermoscopically with halo nevus during planned routine dermoscopic examinations of all melanocytic lesions in 2007–2013. All digital images stored in the computer database were analyzed retrospectively according to the procedure described in the study. The clinical and dermoscopic parameters such as the dermoscopic pattern, color of nevus, special features and description of the surrounding halo were analyzed statistically. Results We analyzed 22 halo nevi (9 in females, 13 in males) in 15 patients (7 females, 8 males) diagnosed during the dermoscopic examination. The mean age of patients during dermoscopic examinations was 18.2 years. Mean patients’ age at HN onset was 15.7 years. Halo nevi occurred the most often as a solitary lesion. The ratio of multiple halo nevi to solitary halo nevus was 5 : 10. Every third halo nevus was located on the posterior trunk upper. In 68.2% of HN cases, the surrounding rim (halo) was characterized by its homogenous, whitish color. Conclusions Dermoscopic patterns such as uniform globular and structureless constituted one-third each of them in all analyzed patterns.
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Abstract
Although pediatric melanoma is a rare disease, diagnosis and management of pigmented lesions in the pediatric population, particularly dysplastic nevi and Spitz nevi, can be challenging. In this article, we provide an overview of pigmented lesions in children, including melanoma and management of melanoma risk factors and melanocytic nevi in the pediatric population. Congenital melanocytic nevi, Spitz nevi, dysplastic and acquired nevi, and changes over time are reviewed. We discuss considerations for excision and management of pigmented lesions in children.
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Affiliation(s)
- Elena B Hawryluk
- Dermatology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Marilyn G Liang
- Dermatology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
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Literature Update on Melanocytic Nevi and Pigmented Lesions in the Pediatric Population. CURRENT DERMATOLOGY REPORTS 2012. [DOI: 10.1007/s13671-012-0023-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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