Cohen Philip R, Gutierrez Nikolas, Erickson Christof P, Calame Antoanella
Dermatology, University of California, Davis Medical Center, Sacramento, USA.
General Practice, United States Naval Mobile Construction Battalion 3, Port Hueneme, USA.
Cureus. 2023 Aug 9;15(8):e43228. doi: 10.7759/cureus.43228. eCollection 2023 Aug.
A halo phenomenon describes a skin neoplasm that is surrounded by a hypopigmented or white halo. Halo lesions have been observed in association with an epithelial neoplasm (seborrheic keratosis), a fibrous lesion (surgical scar), a keratinocyte malignancy (basal cell carcinoma), melanocytic neoplasms, and vascular lesions. Benign lesions (café au lait macules and nevi) and malignant tumors (primary and metastatic melanoma) are melanocytic neoplasms that have developed perilesional halos. Halo nevi are a commonly occurring manifestation of a halo phenomenon; however, perilesional hypopigmented halos have also been observed around nevi in patients following treatment with antineoplastic drugs, acquisition of COVID-19 (infection and vaccine), the occurrence of a visceral tumor (including not only melanoma, but also papillary thyroid carcinoma and neuroendocrine cancer of the lung), surgery (such as the excision of a primary melanoma), and Turner syndrome. A halo phenomenon has also been observed in patients with congenital (capillary malformation-arteriovenous malformation and congenital hemangioma) or acquired (angioma, eruptive pseudoangiomatosis, infantile hemangioma, and lobular capillary hemangioma) vascular lesions. In summary, a halo phenomenon can occur in association with primary lesions of various embryologic derivations. Most commonly, they have been observed in around nevi and vascular tumors. Halo lobular capillary hemangioma can be added to the list of acquired vascular lesions with the potential to develop a halo phenomenon. The preservation of melanocytes with loss of melanin pigment expression in the reported patient suggests the possibility that a post-inflammatory etiology may be responsible for the genesis of her halo lobular capillary hemangioma.
晕轮现象描述的是一种被色素减退或白色晕轮包围的皮肤肿瘤。已观察到晕轮病变与上皮性肿瘤（脂溢性角化病）、纤维性病变（手术瘢痕）、角质形成细胞恶性肿瘤（基底细胞癌）、黑素细胞肿瘤以及血管性病变有关。良性病变（咖啡斑和痣）和恶性肿瘤（原发性和转移性黑色素瘤）是已出现病灶周围晕轮的黑素细胞肿瘤。晕痣是晕轮现象的常见表现；然而，在接受抗肿瘤药物治疗的患者的痣周围、感染新冠病毒（感染和接种疫苗）后、出现内脏肿瘤（不仅包括黑色素瘤，还包括甲状腺乳头状癌和肺神经内分泌癌）、手术后（如原发性黑色素瘤切除）以及特纳综合征患者的痣周围也观察到了病灶周围色素减退晕轮。在患有先天性（毛细血管畸形 - 动静脉畸形和先天性血管瘤）或后天性（血管瘤、爆发性假性血管瘤、婴儿血管瘤和小叶性毛细血管瘤）血管性病变的患者中也观察到了晕轮现象。总之，晕轮现象可与各种胚胎来源的原发性病变相关。最常见的是，它们在痣和血管肿瘤周围被观察到。晕轮小叶性毛细血管瘤可被添加到有发生晕轮现象可能性的后天性血管病变列表中。报告患者中黑素细胞的保留但黑色素色素表达缺失提示炎症后病因可能是其晕轮小叶性毛细血管瘤发生的原因。
