“…Hormonal changes during puberty could influence the expression of this mosaicism and explain the cases which arise at a later age. The association with other cutaneous diseases that show a similar segmental pattern, such as epidermal nevi or hypomelanosis of Ito, may put NH mosaic pattern within a possible twin spot phenomenon 1,3 . NH can be unfrequently associated with systemic disorders, in particular, ocular and neurological malformation, lipoatrophy and skeletal abnormalities 1–3 and recently it has been proposed as a diagnostic marker of Happle–Tinschert syndrome 4 .…”