This mole is almost gone, leaving just the halo.

HALO NEVUS

The halo nevus is a mole surrounded by a white oval or circle. The white halo results from the immune system attacking and removing melanin from the mole and the surrounding skin.

• A completely depigmented circle of skin centered around a pigmented lesion in a child is typical. Multiple lesions are common. This author has had one patient with 35 halo nevi at one time!!
  
• It is common in children for the immune system to attack normal, benign nevi including a cm or so margin of normal skin. Over time, melanin is lost and a white halo surrounds the nevus. Ultimately over several years, the central mole may be completely eradicated.
• In older adults, a melanoma may develop a halo (halo melanoma) and thus great care should be take in this population. One key tipoff is the halo of a halo melanoma tends to be irregular compared to the smooth, round or oval halo of a halo nevus.
• Patients with vitiligo may have one or more halo nevi. In one study of 208 children with vitiligo, 55 (26%) had at least one halo nevus.
  
• Conversely, approximately 20% of patients with halo nevi also have vitiligo, either involving the nevus or at a distant site.
  
• Halo giant congenital nevi may occur.

Treatment, Brief Overview

A complete skin examination should be done for all patients.

It is always important to evaluate the central mole for signs of atypia, e.g. using the ABCDE's as with any other mole. If the central lesion is clinically atypical, it should be removed. In children however, most are benign and no treatment is needed. In contrast, most halo nevi in older adults should be removed as the possibility of melanoma is more likely.

Additional Pictures

Multiple halo nevi on the face.

Multiple Halo nevi on the back.

Two halo nevi, one almost gone.

NOT a halo nevus. This was a halo melanoma. Note the irregular shape, variation in color, and very dark areas.

RegionalDerm

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