An acquired anemic patch developed after a cyst excision: is it a variant of nevus anemicus?

A 53-year-old male presented with a 6-year duration of a child's-palm sized hypopigmented patch located on his neck. He had a history of surgical excision of an epidermal cyst on the neck, and the hypopigmented patch developed about one month after the excision next to the surgery site. Application of cold or heat did not make the lesion distinct from the surrounding skin. Pressure on the lesion by a glass slide made the lesion indistinguishable from surrounding uninvolved lesions. Giving friction to the lesion failed to induce erythematous change, making it clearly visible. Histologically, the lesion showed normal findings with adequate numbers of melanocytes in the basal layer. Herein, we present an interesting case of an acquired anemic patch which developed after a cyst excision. We postulate that nerve damage after surgery that regulates the vascular tone of cutaneous vessels may have been an inducing event of the anemic patch in this patient.