Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Blue Nevi Clinical Presentation

  • Author: Rudolf R Roth, MD; Chief Editor: William D James, MD  more...
 
Updated: Feb 08, 2016
 

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.

Next

Physical

Blue nevi are usually smooth-surfaced, dome-shaped papules that slowly develop from a macule to a papule.[6]

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.[7]

See the images below.

Common blue nevus on the scalp. Common blue nevus on the scalp.
Common blue nevus on the hand. Common blue nevus on the hand.
Previous
Next

Causes

See Pathophysiology. Although blue nevi are most frequently seen on the skin, they have also been reported in the oral cavity, subungually,[8] in lymph nodes, and in organs such as the brain, pulmonary tract, and prostate.

Previous
 
 
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, 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, Southern Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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

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

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, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

References
  1. Phadke PA, Zembowicz A. Blue nevi and related tumors. Clin Lab Med. 2011 Jun. 31(2):345-58. [Medline].

  2. Zembowicz A, Phadke PA. Blue nevi and variants: an update. Arch Pathol Lab Med. 2011 Mar. 135 (3):327-36. [Medline].

  3. Gill M, Celebi JT. B-RAF and melanocytic neoplasia. J Am Acad Dermatol. 2005 Jul. 53(1):108-14. [Medline].

  4. Van Raamsdonk CD, Bezrookove V, Green G, Bauer J, Gaugler L, O'Brien JM, et al. Frequent somatic mutations of GNAQ in uveal melanoma and blue naevi. Nature. 2009 Jan 29. 457 (7229):599-602. [Medline].

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

  6. Di Cesare A, Sera F, Gulia A, Coletti G, Micantonio T, Fargnoli MC, et al. The spectrum of dermatoscopic patterns in blue nevi. J Am Acad Dermatol. 2011 Oct 24. [Medline].

  7. Dailey VL, Hameed O. Blue nevus of the prostate. Arch Pathol Lab Med. 2011 Jun. 135(6):799-802. [Medline].

  8. Causeret AS, Skowron F, Viallard AM, Balme B, Thomas L. Subungual blue nevus. J Am Acad Dermatol. 2003 Aug. 49(2):310-2. [Medline].

  9. Cooper PH. Deep penetrating (plexiform spindle cell) nevus. A frequent participant in combined nevus. J Cutan Pathol. 1992 Jun. 19(3):172-80. [Medline].

  10. Munoz C, Quintero A, Sanchez JL, Ruiz-Santiago H. Persistent blue nevus simulating melanoma. J Am Acad Dermatol. 2004 May. 50(5 Suppl):S118-20. [Medline].

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

  12. 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. 1996 Mar. 20(3):259-72. [Medline].

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

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

  15. Kirschner LS, Sandrini F, Monbo J, Lin JP, Carney JA, Stratakis CA. Genetic heterogeneity and spectrum of mutations of the PRKAR1A gene in patients with the carney complex. Hum Mol Genet. 2000 Dec 12. 9 (20):3037-46. [Medline].

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

  17. Braun RP, Rabinovitz HS, Oliviero M, Kopf AW, Saurat JH. Dermoscopy of pigmented skin lesions. J Am Acad Dermatol. 2005 Jan. 52(1):109-21. [Medline].

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

  19. Di Cesare A, Sera F, Gulia A, Coletti G, Micantonio T, Fargnoli MC, et al. The spectrum of dermatoscopic patterns in blue nevi. J Am Acad Dermatol. 2012 Aug. 67 (2):199-205. [Medline].

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

  21. 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. 1991 Jan. 22(1):52-8. [Medline].

  22. 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. 2000 May. 27(5):218-23. [Medline].

  23. Loghavi S, Curry JL, Torres-Cabala CA, Ivan D, Patel KP, Mehrotra M, et al. Melanoma arising in association with blue nevus: a clinical and pathologic study of 24 cases and comprehensive review of the literature. Mod Pathol. 2014 Nov. 27 (11):1468-78. [Medline].

  24. Lambert WC, Brodkin RH. Nodal and subcutaneous cellular blue nevi. A pseudometastasizing pseudomelanoma. Arch Dermatol. 1984 Mar. 120(3):367-70. [Medline].

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

  26. Novice FM, Collison DW, Burgdorf WHC, et al. Disorders of hyperpigmentation. Novice FM, Collison DW, eds. Handbook of Genetic Skin Disorders. 1st ed. Philadelphia, Pa: WB Saunders; 1994. 195-8.

  27. Rhodes AR. Benign neoplasias and hyperplasias of melanocytes. 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.

Previous
Next
 
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.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.