The "Golden Brown Halo" of the Miescher Nevus
The Miescher nevus (MN) is a relatively firm, brownish to skin-colored, dome-shaped, roundish papule that occurs most commonly on the head and neck.1 It is not uncommon for a terminal hair to emanate from an MN. The MN tends to be quite stable, with little to no change detected during follow-up. The diagnosis of MN is usually easy to make based on the clinical morphological appearance; however, on occasion, it may be difficult to differentiate an MN from a basal cell carcinoma (BCC), especially because dermoscopy can reveal arborizing vessels in both lesions. To our knowledge, this is the first report of a dermoscopic pattern consisting of a golden brown halo that we have observed surrounding many MN (Figure, A, B, and C). This golden brown halo is not seen in BCC (Figure, D). In our experience, the golden halo may be an additional dermoscopic feature that can help differentiate an MN from a BCC.