doi: 10.1016/j.jdcr.2025.01.005.
eCollection 2025 Apr.
Lobular capillary hemangioma with halo phenomenon
Affiliations
- PMID: 40103684
- PMCID: PMC11914741
- DOI: 10.1016/j.jdcr.2025.01.005
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Lobular capillary hemangioma with halo phenomenon
JAAD Case Rep.
.
No abstract available
Keywords: Fontana; Fontana-Masson; MART-1; Masson; Melan-A; T cell; angiokeratoma; angioma; antigen; capillary; eosin; granuloma; halo; hemangioma; hematoxylin; hypopigmentation; lobular; melanin; melanocyte; nevus; phenomenon; pyogenic; recognized; stain.
Conflict of interest statement
None disclosed.
Figures
Clinical appearance of halo phenomenon in a lobular capillary hemangioma. A 50-year-old Caucasian woman had an acquired asymptomatic red lesion on her distal right leg of unknown duration that would occasionally become irritated; previously, it had twice spontaneously bled. Examination of the medial aspect of her distal lower leg (with the calf towards the left and the ankle towards the right) showed a 5.0 × 4.0 millimeter red nodule; it was surrounded by a white epithelial collarette and an asymmetric hypopigmented patch. A tangential excision, using the shave technique, completely removed the lesion. The details of this report have been described, yet the photograph has not been previously published.
Microscopic findings of lobular capillary hemangioma with halo phenomenon. Hematoxylin and eosin staining (A) show a proliferation of capillaries in a fibrotic dermal stroma; there is solar elastosis and a minimal inflammatory infiltrate in the dermis. There is compact orthokeratosis overlying an acanthotic epidermis in the central portion of the lesion. A collarette of epithelium surrounds the vascular tumor in the lateral portion of the lesion; mounds of orthokeratosis project from the epidermis (corresponding to the white scaling observed clinically) and elongated rete ridges extend into the dermis separating the lesional dermis from the adjacent dermis. Fontana-Masson staining (B) reveals an absence of melanin expression in the basal layer of the epidermal collarettes and the immediately bilateral adjacent epidermis (white brackets); however, the basal layer of the epidemis in the center of the lesion and the skin peripheral to the areas of hypopigmentation demonstrates melanin expression (black brackets). MART-1 staining (C) shows melanocytes present in the basal layer of the epidermis that is both overlying the entire vascular lesion and also in the hypopigmented area that not only surrounds the vascular lesion but also includes the epidermal collarette. The microscopic changes of this report have been described, yet the photomicrographs have have not been previously published (A, hematoxylin and eosin, ×2; B, Fontana-Masson, × 2; C, MART-1, ×2).
Halo phenomenon in a lobular capillary hemangioma shows preservation of melanocytes. A higher magnification view of the MART-1 staining of a lobular capillary hemangioma with halo phenomenon shows melanocytes (black arrows) present along the basal layer of the epidermis. Therefore, the loss of melanin pigment expression with the preservation of melanocytes in the white epidermal collarette and hypopigmented perilesional areas is consistent with postinflammatory hypopigmentation being responsible for the pathogenesis of the halo phenomenon that occurred in the lobular capillary hemangioma. The microscopic changes of this report have been described, yet the photomicrographs have not been previously published (MART-1, × 20).
References
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- Koga M., Yoshida Y., Imafuku S. Clinical characteristics of the halo phenomenon in infants with neurofibromatosis 1: a case series. Acta Derm Venereol. 2018;98:153–154. - PubMed
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- Weyant G.W., Chung C.G., Helm K.F. Halo nevus: review of the literature and clinicopathologic findings. Int J Dermatol. 2015;54:e433–e435. - PubMed
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