Prognostic value and clinical significance of halo naevi regarding vitiligo

Background: Vitiligo and halo nevi can present together or separately. Whether it concerns different entities remains unclear. Objectives: To assess the clinical significance of halo nevi, both with respect to the future development of vitiligo, and to the clinical profile and course of vitiligo. Methods: In total 291 patients were included in this study, comparing patients with only halo nevi (group 1; n= 40), to patients with generalized vitiligo without halo nevi (group 2; n= 173) or generalized vitiligo with halo nevi (group 3; n= 78). Results: Patients with only halo nevi (group 1), reported significantly less associated auto-immune diseases (p=0.004), family history of vitiligo (p=0.013) and presence of Koebner phenomenon (p<0.001) compared to generalized vitiligo patients (group 2 + 3). Multiple halo nevi (≥3) were significantly more observed (p=0.002) in patients from group 1 compared to patients from group 3. In group 3, halo nevi were reported prior to the development of vitiligo in 61% (mean time interval of 33.7±5.17 months). No significant correlation could be observed between the presence of halo nevi and the extent, activity or subtype of vitiligo. However, halo nevi in vitiligo patients reduces significantly the risk for associated auto-immune diseases (p=0.02), and age of onset of vitiligo was significantly lower as compared to vitiligo patients without halo nevi (p