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Involvement of T-Cell Immunity in Involution and Presence of Circulating Anti—Nevus Cell IgM Antibodies

Yoshiki Tokura, MD; Katsuji Yamanaka, MD; Hisashi Wakita, MD; Shigeko Kurokawa, MD; Daisuke Horiguchi, MD; Asami Usui, MD; Shigetoshi Sayama, MD; Masahiro Takigawa, MD

Arch Dermatol. 1994;130(8):1036-1041.

Abstract
Background
Halo congenital nevus is a condition in which halo formation is associated with congenital nevocellular nevi. Although several theories have been proposed, the immunologic mechanisms of halo formation and concomitant nevus regression still remain unclear. We presented immunologic findings in a case of halo congenital nevus with unique histologic location of inflammatory cells.

Observations
Histologically, the present case of halo congenital nevus undergoing spontaneous regression showed a marked inflammatory infiltrate with remnants of original nevus cell nests. In the infiltrating T cells, CD8⁺ cells outnumbered CD4⁺ cells and the infiltrate of natural killer cells was not substantial. Direct and indirect immunofluorescence studies demonstrated the presence of IgM antibodies against nevus cells as well as melanoma cells and cultured melanocytes in the patient's serum.

Conclusions
Our findings suggest that both T-cell-mediated immunity and IgM antibodies may be involved in the regression of halo congenital nevus. However, it is important to point out that our results may simply be epiphenomena and not directly responsible for the destruction of nevus cells.

(Arch Dermatol. 1994;130:1036-1041)

Author Affiliations
From the Department of Dermatology, Hamamatsu University School of Medicine (Drs Tokura, Wakita, Kurokawa, and Takigawa); Department of Dermatology, Hamamatsu Medical Center (Dr Yamanaka); Department of Dermatology, Shizuoka City Hospital (Drs Horiguchi and Usui); and Department of Dermatology, Tenri Yorozu Hospital (Dr Sayama), Japan.

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