Halo Medium-Sized Congenital Melanocytic Nevi and Vitiligo Progression in Three Children

A one year-old girl was referred to our dermatology department for assessment of an asymptomatic congenital pigmented lesion on the right posterior flank. Medical history was unremarkable. Dermatologic examination revealed a 30×10 mm homogeneous dark brown plaque with a verrucous surface, which was diagnosed as medium-sized CMN. After seven years of follow-up, the nevus had enlarged proportionally to the child’s growth, and an achromic halo appeared around the nevus (Figure 1). Over the following two years, this achromic halo increased in size with a profound reduction in the CMN. The addition of facial and anogenital achromic patches were noted. Blood tests including thyroid function and autoimmunity were normal. Findings were consistent with a halo nevus in a medium sized CMN and vitiligo.