The natural history of halo nevi: a retrospective case series

Abstract

Background: The time period between onset of depigmentation around the halo nevus (HN) to complete resolution of the nevus and halo has not been well studied.

Objective: We sought to better understand the natural history of the HN.

Methods: A retrospective chart review of patients with a clinical diagnosis of HN selected from a private practice database (1994-2010) was performed. In all, 52 patients with 80 HN were identified. The current stage of the HN was determined by a follow-up questionnaire and physical examination of 36 patients with 56 HN.

Results: Seven HN were excised. Of the remaining 49 HN, 51% (25) demonstrated no change in the halo or nevus after an average of 4.2 years; 14.3% (7) demonstrated partial nevus regression with persistence of the halo after an average of 6.7 years; 4.1% (2) demonstrated complete involution of the nevus with persistent halo depigmentation after an average of 7.7 years; 8.2% (4) demonstrated complete nevus involution with some repigmentation of the halo after an average of 11.8 years; 22.4% (11) demonstrated complete resolution of the nevus with complete repigmentation of the halo after an average of 7.8 years.

Limitation: Some subjects were lost to follow-up. The time of initial HN onset was dependent on patient recall.

Conclusion: These results demonstrate that HN typically persist for a decade or longer. A subgroup may progress through stages of involution with a return to normal-appearing skin, but even these lesions persisted for an average of 7.8 years. Education about the prolonged natural history of HN may reassure patients and avoid unnecessary excision.