Halo nevi named also Sutton's nevi are benign melanocytic lesions occurring especially among adolescents. Halo nevus was first described in the 16th century as a benign, rapidly changing melanocytic lesion with a whitish halo around preexisting nevus. In 1916, Sutton used the term "leukoderma acquisitum centrifugum" for the first time. The incidence of halo nevi in the entire population is about 1%, with no predilection for gender or race. 1 The majority of patients have multiple halo lesions, which are usually located on the back.Clinical examination often shows a disturbing white ring surrounding the nevus. Some authors indicate a familial tendency for halo nevi, or coexistence with atopic dermatitis and autoimmune disorders.Clinically, halo nevi are important "melanoma simulators," which usually appear in children and young adults. Besides, halo phenomenon can arise in atypical nevi, in nonmelanocytic tumors, inflammatory lesions, but also in melanoma. Whitish halo surrounding nevi can be clinically and dermoscopically difficult to distinguish from regression in melanoma. 2,3 It could be notably challenging when "halo" is slightly visible or asymmetric. Reflectance confocal microscopy in
Lichen planus-like keratosis is a common, benign pigmented skin lesion. It should be carefully diagnosed using modern diagnostic tools, such as dermoscopy and confocal microscopy, to avoid misdiagnosis as melanoma or other malignant pigmented lesions.
The diagnosis of melanoma is challenging for both dermatologists and oncologists. Incidence of melanoma increases at a rate of 3–7% per year. Usage of modern tools such as dermoscopy and in vivo reflectance confocal microscopy improve early diagnosis and can save a life. There are a few melanoma simulators which can cause confusion and mislead in the differential diagnosis. This study aims to present skin lesions which can be similar to melanoma in confocal microscopy and to emphasize the importance of a detailed differential diagnosis. We describe five melanocytic lesions similar to melanoma and misleading confocal features. Although in vivo reflectance confocal microscopy is very useful in differentiating melanocytic lesions, histopathology evaluation in cases of melanoma mimics is definitive.
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