Halo naevus (syn. Sutton naevus)

Patient Information Leaflet
Link: Halo naevus

https://www.pcds.org.uk/patient-info-leaflets/halo-naevus

A halo naevus is essentially a benign melanocytic naevus with a white ring or 'halo' around it. It is a benign skin lesion that represents a melanocytic naevus in which an inflammatory infiltrate develops, resulting in a zone of depigmentation surrounding the naevus.

This chapter is set out as follows:

• The cause of the spontaneous loss of pigmentation is unknown but appears to be related to an immunologic destruction of melanocytes. Adding support to this hypothesis is the fact that several patients with halo naevi have a tendency toward the development of vitiligo. Halo naevi may follow the Koebner phenomenon, arising within a mole that has been traumatised

• They present most frequently in older children and young adults. Halo naevi occasionally arise in older individuals
• In fair-skinned individuals a halo naevus is most often recognised during summer months when the surrounding normal skin tans, whereas the halo of depigmentation does not
• Although common melanocytic naevi are those most frequently associated with the halo phenomenon, it may also occur in other naevi such as blue naevi and Spitz naevi
• Natural history - the central naevus gradually disappears over several months, although sometimes this process can take a number of years

Distribution

• Lesions can be single, but are frequently multiple
• They can develop anywhere on the body but are seen most frequently on the trunk, especially the back

Morphology - there are four stages

• A rim of pale skin surrounds the naevus - the width of the halo is variable but is generally of uniform radial distance from the central naevus
• The naevus may become pinker or less pigmented, and eventually disappears
• A circular or oval area of depigmentation persists
• The affected skin gradually returns to its normal colour

• Halo naevi are harmless - no treatment is required
   
• Differentiating a halo naevus from a regressing melanoma is usually straight forward, although a regressing melanoma can have white areas. A melanoma should be suspected in the following:
  • A solitary lesion with an irregular area of depigmentation surrounding/within an 'odd' looking mole
  • A new 'halo naevus' in an older patient
     
• Patients with suspicious lesions should be referred on an urgent skin cancer pathway to Secondary Care