Blue Nevi Clinical Presentation

  • Author: Rudolf R Roth, MD; Chief Editor: William D James, MD   more...
 
Updated: Jan 12, 2012
 

History

  • Once a blue nevus appears, it tends to remain unchanged throughout life. Occasionally, common blue nevi flatten and fade in color. These changes are evenly distributed throughout the lesion.
  • Malignant change in cellular blue nevi may be heralded by a sudden increase in size and occasionally ulceration.
  • Cases of eruptive blue nevi have been reported, some following skin trauma, such as sunburn.
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Physical

  • Blue nevi are usually smooth-surfaced, dome-shaped papules that slowly develop from a macule to a papule.[5]
  • Common blue nevi tend to be smaller than 1 cm, and cellular blue nevi tend to be larger than 1 cm.
  • Blue nevi are most commonly found on the skin. Rare cases of common blue nevi have been reported in the vagina, the spermatic cord, the uterine cervix, the lymph node, the prostate, the oral mucosa, and the bronchus.[6] Common blue nevus on the scalp. Common blue nevus on the scalp. Common blue nevus on the hand. Common blue nevus on the hand.
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Causes

  • See Pathophysiology. Although blue nevi are most frequently seen on the skin, they have also been reported in the oral cavity, subungually,[7] in lymph nodes, and in organs such as the brain, pulmonary tract, and prostate.
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Contributor Information and Disclosures
Author

Rudolf R Roth, MD  Medical Director, Department of Dermatology, Penn Medicine at Radnor; Associate Professor of Clinical Dermatology, Department of Dermatology, University of Pennsylvania School of Medicine

Rudolf R Roth, MD is a member of the following medical societies: American Academy of Dermatology and Association of Military Dermatologists

Disclosure: Nothing to disclose.

Coauthor(s)

Scott M Acker, MD  Associate Professor, Director of Dermatopathology, Departments of Dermatology and Pathology, University of Alabama at Birmingham

Scott M Acker, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society for Clinical Pathology, and Southern Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Terry L Barrett, MD  Clinical Professor of Dermatology and Pathology, University of Texas Southwestern School of Medicine; Director, ProPath Dermatopathology, Dallas, Texas

Terry L Barrett, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, College of American Pathologists, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Lester F Libow, MD  Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

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  11. Ferrara G, Soyer HP, Malvehy J, et al. The many faces of blue nevus: a clinicopathologic study. J Cutan Pathol. Jul 2007;34(7):543-51. [Medline].

  12. Tsunemi Y, Saeki H, Tamaki K. Blue naevus with pigment network-like structure on dermoscopy. Acta Derm Venereol. 2008;88(4):412-3. [Medline].

  13. Barnhill RL, Barnhill MA, Berwick M, Mihm MC Jr. The histologic spectrum of pigmented spindle cell nevus: a review of 120 cases with emphasis on atypical variants. Hum Pathol. Jan 1991;22(1):52-8. [Medline].

  14. Moreno C, Requena L, Kutzner H, de la Cruz A, Jaqueti G, Yus ES. Epithelioid blue nevus: a rare variant of blue nevus not always associated with the Carney complex. J Cutan Pathol. May 2000;27(5):218-23. [Medline].

  15. Carney JA. Psammomatous melanotic schwannoma. A distinctive, heritable tumor with special associations, including cardiac myxoma and the Cushing syndrome. Am J Surg Pathol. Mar 1990;14(3):206-22. [Medline].

  16. Carney JA, Ferreiro JA. The epithelioid blue nevus. A multicentric familial tumor with important associations, including cardiac myxoma and psammomatous melanotic schwannoma. Am J Surg Pathol. Mar 1996;20(3):259-72. [Medline].

  17. Carney JA, Gordon H, Carpenter PC, Shenoy BV, Go VL. The complex of myxomas, spotty pigmentation, and endocrine overactivity. Medicine (Baltimore). Jul 1985;64(4):270-83. [Medline].

  18. Carney JA, Headington JT, Su WP. Cutaneous myxomas. A major component of the complex of myxomas, spotty pigmentation, and endocrine overactivity. Arch Dermatol. Jul 1986;122(7):790-8. [Medline].

  19. Blackford S, Roberts DL. Familial multiple blue naevi. Clin Exp Dermatol. Jul 1991;16(4):308-9. [Medline].

  20. Emley A, Nguyen LP, Yang S, Mahalingam M. Somatic mutations in GNAQ in amelanotic/hypomelanotic blue nevi. Hum Pathol. Jan 2011;42(1):136-40. [Medline].

  21. Maize JC, LeBoit PE, Metcalf JS, et al. Neoplasms of melanocytes. In: Maize J, Burgdorf WHC, Hurt MA, et al, eds. Cutaneous Pathology. Philadelphia, Pa: Churchill Livingstone; 1998:677-82.

  22. Novice FM, Collison DW, Burgdorf WHC, et al. Disorders of hyperpigmentation. In: Novice FM, Collison DW, eds. Handbook of Genetic Skin Disorders. ed. Philadelphia, Pa: WB Saunders; 1994:195-8.

  23. Rhodes AR. Benign neoplasias and hyperplasias of melanocytes. In: Freedberg IM, Eisen AZ, Wolff K, et al, eds. Fitzpatrick's Dermatology in General Medicine. 5th ed. New York, NY: McGraw-Hill; 1999:1037-43.

  24. Rodriguez HA, Ackerman LV. Cellular blue nevus. Clinicopathologic study of forty-five cases. Cancer. Mar 1968;21(3):393-405. [Medline].

  25. Temple-Camp CR, Saxe N, King H. Benign and malignant cellular blue nevus. A clinicopathological study of 30 cases. Am J Dermatopathol. Aug 1988;10(4):289-96. [Medline].

  26. Zembowicz A, Mihm MC. Dermal dendritic melanocytic proliferations: an update. Histopathology. Nov 2004;45(5):433-51. [Medline].

 
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Common blue nevus on the scalp.
Common blue nevus on the hand.
Common blue nevus. Numerous elongated dendritic melanocytes with a subepidermal grenz zone. Courtesy of Rose Elenitsas, MD.
Cellular blue nevus. Deep proliferation of dendritic melanocytes, broader at the surface than the base, with islands of paler cells with larger nuclei. Courtesy of Rose Elenitsas, MD.
 
 
 
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