Spontaneous Regression of Divided Nevus of the Eyelid Evaluated by Dermoscopy : Is it Hypopigmentation After Regression or Vitiligo
Background: Divided nevus, also known as “kissing nevus,” is a rare form of congenital melanocytic nevus that occurs on opposing margins of upper and lower eyelids. A paucity of literature on this rare anomaly exists, with most being case reports and series. Moreover, regression of this lesion was...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Universitas Indonesia
2020-06-01
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| Series: | JDVI (Journal of General Procedural Dermatology & Venereology Indonesia) |
| Subjects: | |
| Online Access: | http://www.jgenprodvi.ui.ac.id/index.php/jdvi/article/view/212/pdf |
| Summary: | Background: Divided nevus, also known as “kissing nevus,” is a rare form of congenital melanocytic nevus
that occurs on opposing margins of upper and lower eyelids. A paucity of literature on this rare anomaly
exists, with most being case reports and series. Moreover, regression of this lesion was rarely reported.
Case Illustration: We present a rare case of congenital divided nevus of the eyelid that regressed after eight
years, confirmed with dermoscopy. A six-year-old boy presented to the Dharmais National Cancer Hospital
with two pigmented macules on the upper and lower right eyelid since birth. A year ago, the lesions started
gradually disappearing and were replaced by a hypopigmented area. We evaluated the clinical and
dermoscopic findings for two consecutive years. The dermoscopy showed pseudopigment networks,
surrounded by a hypopigmented area resembling a halo. The pigmented lesions cleared with no residual
lesions.
Discussion: The dermoscopic findings of the patient resemble a solar lentigo characterized by
pseudopigment networks, a feature caused by the relatively flattened rete ridge on the face. The
hypopigmented area reflects a regression process, like the halo nevus, and is accompanied by leukotrichia
of the eyelashes, a feature usually found in patients with vitiligo. Regression of the divided nevus is related to
an autoimmune process. A similar mechanism was also found in vitiligo. Since no atypical findings were
present in this patient, we recommend only observation.
Conclusion: Divided nevus is a rare case. We present a case of congenital divided nevus of the eyelid that
regressed spontaneously. Clinical and dermoscopic findings of hypopigmented regression area were similar
with vitiligo, which might share similar pathological mechanisms. |
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| ISSN: | 2460-7991 2460-7991 |