Background: Meyerson's phenomenon is characterized by a symmetrical halo of erythema and scale around central, mostly melanocytic lesions. Objective: Our aim was to describe the dermoscopic and reflectance confocal microscopy (RCM) features of melanocytic tumors less frequently associated with Meyerson's phenomenon, with histopathology and immunohistochemistry correlation. Methods: Clinical, dermoscopic and RCM images of 4 histopathologically confirmed melanocytic tumors associated with Meyerson's phenomenon (3 dysplastic compound nevi and 1 melanoma) were retrospectively collected, with additional immunohistochemical analysis. Results: RCM showed in vivo features of both melanocytic and spongiotic nature of the lesion associated with Meyerson's phenomenon, even in cases with absent halo. Our study also supported the involvement of immune-mediated CD4+ T lymphocyte mechanisms and Langerhans cells. Conclusion: Our case series supports the potential of RCM in the evaluation of tumoral and inflammatory skin diseases. RCM features of rare Meyerson's melanoma were also described for the first time.