Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(4):e2022226 1

Dermoscopic Changes in Nevi During an Atopic 
Dermatitis Flare-up

Sara Pilar Herrero-Ruiz1, Anastasia Alejandra Garrido-Ríos1, Helena Álvarez-Garrido1, 
Laura Fernández de la Fuente1, Begoña Echeverría-García1, Jesús Borbujo1

1 Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain

Citation: Herrero-Ruiz SP, Garrido-Ríos AA, Álvarez-Garrido H, Fernández de la Fuente L, Echeverría-García B, Borbujo J. Dermoscopic 
changes in nevi during an atopic dermatitis flare-up. Dermatol Pract Concept. 2022;12(4):e2022226. DOI: https://doi.org/10.5826/
dpc.1204a226

Accepted: March 29, 2022; Published: October 2022

Copyright: ©2022 Herrero Ruiz et al. This is an open-access article distributed under the terms of the Creative Commons  
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted 
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Sara Pilar Herrero Ruiz, MD, Department of Dermatology, Hospital Universitario de Fuenlabrada, 2 Molino Street, 
Fuenlabrada, Madrid, Spain 28942. E-mail: sarapilar.herrero@salud.madrid.org

Case presentation

A 34-year-old male with a personal history of atopic ec-

zema attended his annual digital dermoscopic control with 

a three-week flare-up of atopic dermatitis.  On examination, 

he had scaly erythematous and eczematous plaques at the 

back and the flanks. Comparing the dermoscopic images we 

observed a global attenuation of the reticular pattern, even 

close to disappearance in some areas, and a pink-reddish col-

oration background in several nevi (Figure 1). We appreci-

ated these changes in nevi located in areas affected with the 

atopic dermatitis flare-up but also in nevi in healthy skin.

Teaching point

The Meyerson phenomenon consists of an eczematous halo 

surrounding a melanocytic lesion [1]. The dermoscopic 

features in this phenomenon have been reported as the pig-

mented pattern - reticular and/or globular - encircled by 

dotted vessels associated with crust, without changes in the 

dermoscopic features of the involved melanocytic lesions [2]. 

However, in our patient the dermoscopic changes affected 

all the surface of the nevi and not all of them had clinical 

eczema. These changes are not consistent with previous de-

scriptions of the Meyerson nevi.

It is known that in the reticular pattern, the pigmented 

lines correlate with the inter-papillar ridges and the holes of 

the network correspond to the dermal papillae. Thus, these 

dermoscopic findings may be explained by the histopatho-

logic changes found in atopic dermatitis. Acute lesions of 

dermatitis show epidermal spongiosis and a perivascular in-

filtrate around vessels in the papillary dermis. These changes 

may be responsible for the attenuation of the reticular pat-

tern and the pink-reddish background coloration.



2 Image Letter | Dermatol Pract Concept. 2022;12(4):e2022226

References

1. Panagou E, Heelan K. Meyerson Nevus. J Cutan Med Surg. 

2018;22(1):84. DOI: 10.1177/1203475417721426. PMID: 

29309239.

2. Oliveira A, Arzberger E, Massone C, Fink-Puches R,  Zalaudek 

I, Hofmann-Wellenhof R. Dermoscopy, reflectance confo-

cal microscopy and immunohistochemical analysis in mela-

nocytic lesions with Meyerson’s phenomenon. Dermatology. 

2014;229(4):297-305. DOI: 10.1159/000365657. PMID: 

25472722.

Figure 1. Three examples of the dermoscopic findings in nevi before (A, C, E) and during (B, D, F) the 

atopic dermatitis episode.