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Section Editor: Albert C. Yan, MD
Assistant Section Editor: Samir S. Shah, MD

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Arch Pediatr Adolesc Med. 2007;161(5):472. doi:10.1001/archpedi.161.5.472.
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DENOUEMENT AND DISCUSSION: MEYERSON PHENOMENON WITHIN A CONGENITAL MELANOCYTIC NEVUS

The Meyerson phenomenon refers to a localized eczematous eruption that has been most commonly described in association with acquired melanocytic nevi (Figure 2); such a lesion may be referred to as a Meyerson nevus.1,2 The terms halo dermatitis and halo eczema are also frequently used to describe such nevi.2,3 A halo nevus, however, is a different entity and refers clinically to a nevus that is surrounded by a rim of hypopigmentation. Halo nevi may eventuate in complete disappearance of the associated pigmented lesion, whereas this is not seen with Meyerson nevi.

Place holder to copy figure label and caption
Figure 2.

Erythematous scaly plaque with minimal crust surrounding an acquired melanocytic nevus.

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The Meyerson phenomenon within nevi is not frequently described in dermatology textbooks, though the incidence is likely not rare. Such lesions are most frequently described in otherwise healthy young adult men and demonstrate a predilection for the trunk and proximal extremities.4 Published accounts of Meyerson nevi in infancy, such as the case presented here, are much less frequent. The pathogenesis of the eczematous reaction is not known, but immunological mechanisms may be crucial, as discussed by Brandt et al5 in describing a patient who developed halo nevi and vitiligo following excision of a Meyerson nevus. Although generally limited to a single melanocytic lesion, involvement of numerous nevi in a single patient has been described.6 Pruritus is not uncommon, but involved nevi are not likely to be otherwise bothersome to patients. The Meyerson phenomenon is typically described in association with benign acquired nevi, though a small case series of patients who had involvement of atypical nevi has been reported.7

Similar eczematous reactions have also been described in nonmelanocytic lesions, such as seborrheic keratoses, basal cell carcinomas, squamous cell carcinomas, dermatofibromas, keloids, and congenital capillary malformations (eg, port-wine stains).4,5,8,9 When this phenomenon is observed in overlying nuchal-occipital capillary malformations, the dermatitis may be quite difficult to treat, and in such cases, treatment of the malformation with a pulsed dye laser may expedite resolution of the dermatitis.9

The Meyerson phenomenon is generally regarded as self-limited, and as such, the dermatitis should clear within a few months and may not require treatment. However, local treatment of the involved skin with topical midpotency corticosteroids may provide acceptable relief of associated pruritus with possible total clearance of the dermatitis. Despite resolution of the dermatitis, the pigmented lesion will persist.10 If the eczematous reaction recurs or persists despite treatment, excision of the nevus could be undertaken with expected subsequent clearance of the dermatitis.11 Excision may be limited to the pigmented lesion and need not include the halo of dermatitis.12

Histologic evaluation of excised Meyerson nevi will demonstrate nests of nevus cells distributed in a pattern typical of the clinical appearance (eg, compound nevus or with features consistent with a congenital melanocytic nevus). There is no microscopic evidence of regression of the pigmented lesion. Histologic features of parakeratosis, acanthosis, and spongiotic changes noted in association with a superficial chronic lymphocytic infiltrate are consistent with the clinical picture of a superimposed dermatitis.4

Correspondence: Joanna M. Burch, MD, Department of Dermatology, University of Colorado, PO Box 6510, Mail Stop F703, Aurora, CO 80045 (joanna.burch@uchsc.edu).

Accepted for Publication: August 1, 2006.

Author Contributions:Study concept and design: Tauscher and Burch. Acquisition of data: Tauscher and Burch. Analysis and interpretation of data: Tauscher and Burch. Drafting of the manuscript: Tauscher. Critical revision of the manuscript for important intellectual content: Tauscher and Burch. Study supervision: Burch.

Financial Disclosure: None reported.

Meyerson  LB A peculiar papulosquamous eruption involving pigmented nevi. Arch Dermatol 1971;103510- 512
PubMed Link to Article
Nicholls  DSMason  G Halo dermatitis around a melanocytic naevus: Meyerson's naevus. Br J Dermatol 1988;118125- 129
PubMed Link to Article
Fernandez Herrera  JMAragues Montanes  MFraga Fernandez  JDiez  G Halo eczema in melanocytic nevi. Acta Derm Venereol 1988;68161- 163
PubMed
McKee  PCalonje  EGranter  S Pathology of the Skin: With Clinical Correlations. Vol 23rd ed Philadelphia, Pa Elsevier Mosby2005;
Brandt  OChristophers  EFolster-Holst  R Halodermatitis followed by the development of vitiligo associated with Sutton's nevi. J Am Acad Dermatol 2005;52(suppl 1)S101- S104
PubMed Link to Article
Vega  JAngel Rodriquez  MMartinez  M Eczematous halo reaction in congenital pigmented nevus. Int J Dermatol 2003;42895
PubMed Link to Article
Petit  AViney  CGaulier  ASigal  M Coexistence of Meyerson's with Sutton's naevus after sunburn. Dermatology 1994;189269- 270
PubMed Link to Article
Elenitsas  RHalpern  A Eczematous halo reaction in atypical nevi. J Am Acad Dermatol 1996;34357- 361
PubMed Link to Article
Tay  YKMorelli  JWeston  W Inflammatory nuchal-occipital port-wine stains. J Am Acad Dermatol 1996;35811- 813
PubMed Link to Article
Hofer  T Meyerson phenomenon within a nevus flammeus: the different eczematous reactions within port-wine stains. Dermatology 2002;205180- 183
PubMed Link to Article
Brenan  JKossard  SKrivanek  J Halo eczema around melanocytic nevi. Int J Dermatol 1985;24226- 229
PubMed Link to Article
Cox  NHBloxham  CLawrence  C Halo eczema: resolution after excision of the central nevus alone. Clin Exp Dermatol 1991;1666- 67
PubMed Link to Article

Figures

Place holder to copy figure label and caption
Figure 2.

Erythematous scaly plaque with minimal crust surrounding an acquired melanocytic nevus.

Graphic Jump Location

Tables

References

Meyerson  LB A peculiar papulosquamous eruption involving pigmented nevi. Arch Dermatol 1971;103510- 512
PubMed Link to Article
Nicholls  DSMason  G Halo dermatitis around a melanocytic naevus: Meyerson's naevus. Br J Dermatol 1988;118125- 129
PubMed Link to Article
Fernandez Herrera  JMAragues Montanes  MFraga Fernandez  JDiez  G Halo eczema in melanocytic nevi. Acta Derm Venereol 1988;68161- 163
PubMed
McKee  PCalonje  EGranter  S Pathology of the Skin: With Clinical Correlations. Vol 23rd ed Philadelphia, Pa Elsevier Mosby2005;
Brandt  OChristophers  EFolster-Holst  R Halodermatitis followed by the development of vitiligo associated with Sutton's nevi. J Am Acad Dermatol 2005;52(suppl 1)S101- S104
PubMed Link to Article
Vega  JAngel Rodriquez  MMartinez  M Eczematous halo reaction in congenital pigmented nevus. Int J Dermatol 2003;42895
PubMed Link to Article
Petit  AViney  CGaulier  ASigal  M Coexistence of Meyerson's with Sutton's naevus after sunburn. Dermatology 1994;189269- 270
PubMed Link to Article
Elenitsas  RHalpern  A Eczematous halo reaction in atypical nevi. J Am Acad Dermatol 1996;34357- 361
PubMed Link to Article
Tay  YKMorelli  JWeston  W Inflammatory nuchal-occipital port-wine stains. J Am Acad Dermatol 1996;35811- 813
PubMed Link to Article
Hofer  T Meyerson phenomenon within a nevus flammeus: the different eczematous reactions within port-wine stains. Dermatology 2002;205180- 183
PubMed Link to Article
Brenan  JKossard  SKrivanek  J Halo eczema around melanocytic nevi. Int J Dermatol 1985;24226- 229
PubMed Link to Article
Cox  NHBloxham  CLawrence  C Halo eczema: resolution after excision of the central nevus alone. Clin Exp Dermatol 1991;1666- 67
PubMed Link to Article

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