Halo eczema and junctional naevi: a case report

[Disseminated perinaevic Meyerson phenomenon revealing melanoma]

BACKGROUND

Meyerson phenomenon (MP) consists of an eczematous reaction occurring around a pre-existing dermatologic lesion that is usually melanocytic and generally benign, and which is known as a Meyerson naevus. We report a case of multiple Meyerson naevi revealing melanoma, which itself was surrounded by a halo of eczema.

PATIENTS AND METHODS

A 55-year-old man of phototype III with atopic eczema presented for pruritic eczema present for a fortnight, found solely on and around the naevi on his trunk and at roots of his limbs. One of the melanocytic lesions affected by these Meyerson phenomena was clinically atypical and had been active for several years. Excision confirmed the diagnosis of level II extensive superficial melanoma measuring 0.75 mm in thickness and associated with lesional and perilesional eczematous remodelling. After surgery involving a 1-cm excision margin and local corticosteroid therapy of the eczema, the Meyerson phenomenon subsided with complete remission of the melanoma at 1 year.

DISCUSSION

Meyerson phenomenon can affect one or more naevi at the same time; it is generally transient, may recur on occasion, and has a favourable outcome either spontaneously or with corticosteroid treatment. When not removed for histological verification, the melanocytic lesion regains its initial appearance following resolution of the phenomenon. MP differs from Sutton phenomenon (SP), which is a perinaevic vitiligo reaction leading to complete or partial regression of the melanocytic lesion, which may be either benign or malignant.

CONCLUSION

This case of Meyerson phenomenon revealing melanoma shows that the melanocytic lesions targeted by MP are not necessarily benign.

Eczematous halo reaction in atypical nevi

Meyerson's nevus has been described as a melanocytic nevus with an associated eczematous halo reaction. We describe four patients with eczematous halos developing around atypical nevi, a finding not previously reported. Biopsy specimens revealed eosinophilic spongiosis in addition to the previously reported spongiotic dermatitis.

Halo dermatitis in children

Halo dermatitis is a pruritic, eczematous eruption on pigmented nevi and halo nevi in young adults. It may be mistaken for nummular eczema, psoriasis, or fungal skin infection. Awareness of halo dermatitis will possibly reveal more cases in children, which have been reported only rarely.

Halo eczema--resolution after excision of the central naevus alone

We describe a patient with halo eczema around a benign pigmented compound naevus. The eczema resolved after excision of the central naevus alone; this allowed histological assessment of the naevus without the need for a large excision or for additional topical therapy.

Halo eczema surrounding seborrhoeic keratoses: an example of perilesional nummular dermatitis

Two patients developed halo eczema around isolated seborrhoeic keratoses and in one individual similar halo eczema developed around the nipples. This phenomenon which was previously described with melanocytic naevi has been associated with a number of different central lesions and can be readily recognised. Both the clinical pattern and histopathology suggest that this phenomenon may represent a localised form of nummular dermatitis with a predilection for elevated lesions.

Halo dermatitis around a melanocytic naevus: Meyerson's naevus

A case of halo dermatitis (eczema) around a pigmented naevus is reported. This appears to be a not uncommon condition which is not described in major dermatology textbooks. The relevant literature is reviewed, and the eponym 'Meyerson's naevus' is suggested.

Halo eczema around melanocytic nevi

Nine patients developed multiple areas of eczema surrounding centrally located pigmented nevi. There was no significant history of atopy or evidence of external contact factors to account for the reaction. The eczema did not appear to influence the central melanocytic nevi, which persisted after resolution of the inflammation. The pathogenesis of this striking phenomenon remains unclear but differs from that associated with classical halo nevi.