Halo Seborrheic Keratosis in a Patient of Color With Vitiligo

A 73-year-old woman with Fitzpatrick skin type V presented with a long-standing brownish-black, three-tone macule on the right anterior thigh that developed a sharply demarcated depigmented halo. She also exhibited depigmented patches on the buttocks, hands, and feet consistent with vitiligo. Horizontal excision with histopathology confirmed seborrheic keratosis (SK) without atypia. This case highlights that the halo phenomenon can occur in non-melanocytic lesions, including SK,1 a presentation that may mimic melanoma and complicate diagnosis in richly pigmented skin.2,3 We review halo SK, discuss dermoscopic–pathologic features that distinguish it from melanoma and adult-onset halo nevus, and summarize evidence-based therapies for coexisting vitiligo, including topical ruxolitinib 1.5% cream and narrowband UVB (NB-UVB).4,5 &nbsp.