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Rarely, development of a halo phenomenon in a melanocytic nevus can be predated, especially in children, by a preceding elevated or verrucous and crusted surface

As the cells become weaker, they become more vulnerable to damage or apoptosis (cell death) from even small reductions in perfusion, which can occur if the individual becomes dehydrated or overheated, undergoes surgery, has a drop in blood pressure, engages is excess physical activity, has untreated sleep apnea, or experiences a traumatic shock