Halo naevus (syn. Sutton naevus)

Latest update 16/06/09

Key diagnostic features

• Age of presentation – halo naevi are relatively common and present most frequently in older children and young adults
• Distribution – the back is the most common site
• Appearance
  • Frequently multiple
  • An evenly distributed circular zone of hypopigmentation surrounds a pre-existing melanocytic naevus
  • In Caucasian skin a halo naevus is most often recognized during summer months when the surrounding normal skin tans, whereas the halo of depigmentation does not
• Natural history - the central naevus gradually disappears over several months, although sometimes this process can take a number of years
• Differentiating a halo naevus from a regressing melanoma - the diagnosis of a halo naevus is usually straight forward. 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

Management

• Patients with classical halo naevi can be reassured without the need for excision. Patients should be warned that the depigmented areas will burn easily due to the lack of melanocytes
• If the lesion is suspicious of a melanoma or is in any way atypical the patient must be referred urgently to dermatology on a 2-week wait

	Figure 1 – Halo naevus Lesion on the right unaffected
	Figure 2 – Multiple halo naevi
	Figure 3 – Dermoscopic view of a halo naevus in figure 2
	Figure 4 – The same lesion as in figure 3 but three months later Note the reduction in pigmentation