Association between halo nevi and melanoma in adults: A multicenter retrospective case series

Sequential Dermoscopy and Reflectance Confocal Microscopy Paired With Pigmented Lesion Assay Gene Expression Profiling for In Vivo Monitoring of Multiple Halo Nevi on an Adult Patient

The halo nevus is characterized by a ring of depigmentation appearing around an acquired or congenital melanocytic nevus. When observed in children, halo nevi are generally not a cause of concern. However, adult-onset halo nevi have an associated risk of primary cutaneous melanoma that corresponds to the risk of melanoma in patients with atypical nevi or a personal/familial history of melanoma. Thus, new-onset halo nevi in adults requires close follow-up and monitoring for malignancy. Herein we present a case of an adult patient who received sequential digital dermoscopy, reflectance confocal microscopy, and pigmented lesion assay gene expression profiling to monitor two halo nevi over a three-month period.

The delicate relation between melanocytes and skin immunity: A game of hide and seek

Melanocytes exhibit a complex and intriguing relationship with the skin immune response, leading to several clinical conditions. In some disorders, inappropriate melanocyte destruction (e.g., vitiligo, halo naevi) is problematic, while in others, immune tolerance should be broken (melanoma). Important parts of the dysregulated pathways have been unraveled in pigment disorders, ranging from upregulated interferon (IFN)-γ signaling to memory T cells, regulatory T cells, and immune checkpoints. Although a network of many factors is involved, targeting key players such as IFN-γ or checkpoint inhibitors (e.g., programmed death-ligand 1 (PD-L1)] can shift the balance and lead to impressive outcomes. In this review, we focus on the immunological mechanisms of the most common inflammatory disorders where the interaction of the immune system with melanocytes plays a crucial role. This can provide new insights into the current state of melanocyte research.