Dermoscopy, Reflectance Confocal Microscopy and Immunohistochemical Analysis in Melanocytic Lesions with Meyerson's Phenomenon

Abstract

Background: Meyerson's phenomenon is characterized by a symmetrical halo of erythema and scale around central, mostly melanocytic lesions. Objective: Our aim was to describe the dermoscopic and reflectance confocal microscopy (RCM) features of melanocytic tumors less frequently associated with Meyerson's phenomenon, with histopathology and immunohistochemistry correlation. Methods: Clinical, dermoscopic and RCM images of 4 histopathologically confirmed melanocytic tumors associated with Meyerson's phenomenon (3 dysplastic compound nevi and 1 melanoma) were retrospectively collected, with additional immunohistochemical analysis. Results: RCM showed in vivo features of both melanocytic and spongiotic nature of the lesion associated with Meyerson's phenomenon, even in cases with absent halo. Our study also supported the involvement of immune-mediated CD4+ T lymphocyte mechanisms and Langerhans cells. Conclusion: Our case series supports the potential of RCM in the evaluation of tumoral and inflammatory skin diseases. RCM features of rare Meyerson's melanoma were also described for the first time.

Sudden eruption of multiple Meyerson naevi

“…When MP occurs around a benign pigmented neavus, it is called Meyerson naevus [1][2][3] . MP has been reported encircling different lesions including naevus flammeus [4,5] , acquired melanocytic naevus [1] , congenital melanocytic naevus [6,7] , seborrhoeic keratosis, stucco-keratosis, keloid, benign lentigo, insect bite, basal cell carcinoma, squamous cell carcinoma [8] , dermatofibroma [9] , atypical naevus [10] , and melanoma [10][11][12][13] . The pathogenesis of MP is still not well understood.…”

“…The pathogenesis of MP is still not well understood. Some reported data suggest that the mechanism includes the interaction between CD4+ T-cells and increased expression of intercellular cell adhesion molecule 1 (ICAM-1) [14] as well as the involvements of Langerhans cells [10] and the T-lymphocytes lacking the interleukin-2 receptor [15] .…”

Meyerson Phenomenon: Report of Three Cases

“…Since then similar reaction, also called Meyerson's phenomenon or halo eczema, has been described around various melanocytic (common acquired nevus, congenital nevus, dysplastic nevus, Spitz nevus, melanoma) and non-melanocytic (sebaceous nevus, seborrheic keratosis, dermatofibroma, nevus flammeus, basal cell carcinoma and squamous cell carcinoma) tumors [2]. By now, different causes of Meyerson phenomenon have been proposed, including sunburns, atopic predisposition, chemotherapy and interferon-α treatment, but the exact reason of such reaction remains unknown [3,4].…”

“…Lesions may be asymptomatic or pruritic and accompanied by eczema-like rash on healthy skin. More often Meyerson phenomenon occurs in males, locates on the trunk or proximal extremities [3][4][5]. The eczematous reaction doesn't modify the dermoscopic structures of the lesion, but can make them look blurred [6].…”

“…The eczematous reaction doesn't modify the dermoscopic structures of the lesion, but can make them look blurred [6]. Dermoscopic patterns mainly depend on type of the lesion around which Meyerson phenomenon occurs and are combined with typical features of eczema -dotted vessels, scales and yellow crusts [3]. Histopathology reveals spongiosis, vesiculation and parakeratosis in the epidermis and superficial inflammatory infiltration in the dermis, associated with lymphocytic exocytosis.…”