Combination of vitiligo and Sutton`s nevus. A case report

Background. Halo nevus (Sutton`s nevus) and vitiligo are multifactorial diseases with a hereditary predisposition and with the leading role of autoimmune mechanism of melanocyte destruction in their development. Each of these conditions as an independent pathology is a well-studied disease from the group of dyschromias, their clinical signs are described in detail, a sufficient amount of data on dermatoscopic and immunohistochemical pictures has been accumulated. The incidence of the combination of vitiligo and Sutton nevus (SN), according to the literature, varies from 18 to 26% of cases, since SN is not always considered as a separate nosology. The high frequency of association of these dyschromias is attributable to common cell-mediated autoimmune mechanisms of their development. Their long-term chronic progressive course significantly reduces the quality of life of patients, often leading to deep psychosocial experiences, especially when exposed areas of the skin (face, hands) are affected. When SN appears against the background of existing vitiligo, as well as when halo nevus-associated leukoderma appears, difficulties in making a diagnosis arise, which requires differential diagnostics based on clinical and dermatoscopic pictures of the disease to determine the tactics of patient management.

Description of the clinical case. The article presents author’s own clinical observation of the long-term existence of a combination of vitiligo and multiple SN in a 22-year-old patient. Multiple SN began to form sequentially around congenital nevi a year after the onset of vitiligo. Dermatoscopic examination revealed that the vitiligo foci were at different stages of development, while the SN had the same structure. The absence of spontaneous regression or partial repigmentation of SN over a long period of time is a reason for regular clinical and dermatoscopic monitoring of the patient.

Conclusion. The presented case raises physicians’ awareness of the possibility of combining vitiligo and SN and the nuances of differential diagnosis of these dyschromias based on clinical and dermatoscopic criteria.