eMedicine Specialties > Dermatology > Benign Neoplasms

Blue Nevi: Follow-up

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
Coauthor(s): Scott M Acker, MD, Associate Professor, Director of Dermatopathology, Departments of Dermatology and Pathology, University of Alabama at Birmingham
Contributor Information and Disclosures

Updated: Mar 10, 2009

Follow-up

Complications

  • Common blue nevi are clinically benign. Lesions tend to persist unchanged throughout life.
  • Cellular blue nevi are usually clinically benign. Because of their large size, biopsy and excision tend to be performed more often on cellular blue nevi than on common blue nevi.
  • Rare cases of malignant melanoma have been reported to arise in cellular blue nevi. Any change in these lesions is an indication for biopsy or excision.

Prognosis

  • The prognosis of blue nevi is excellent.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider the diagnosis of malignant melanoma in a changing pigmented lesion is a pitfall.

Special Concerns

  • Carney syndrome (complex)12,13,14,15
    • Carney syndrome (complex) is the rare association of blue nevi with other cutaneous and systemic findings. This condition is thought to arise in an autosomal dominant fashion.
    • Synonyms include lentigines, atrial myxomas, mucocutaneous myxomas, and blue nevi (LAMB) and nevi, atrial myxomas, myxoid tumors (neurofibromas), and ephelides (NAME).
    • Few-to-many blue nevi, ephelides, and mucocutaneous lentigines are found in approximately half the patients. Most often, they are noted on the head and the neck. Lesions may also be noted on the extremities and the genitalia. Lesions arise after birth and develop throughout life. Skin lesions usually precede the detection of cardiac myxomas.
    • Patients with 2 or more clinical findings should undergo a complete evaluation for other associated findings. First-degree relatives of these patients should also undergo an evaluation.
    • Additional associations reported with Carney syndrome (complex) include myxoid fibroadenoma of the breast, growth hormone producing pituitary adenoma causing acromegaly, pheochromocytoma, Sertoli cell tumor of the testes, myxoid uterine leiomyomas, acoustic neuroma, blue nevi, and psammomatous melanotic schwannoma.
  • Familial multiple blue nevi16
    • From birth, multiple lesions are present on the head and the neck, the trunk, the extremities, and the sclera. This condition is not associated with other cutaneous or systemic findings.
    • This condition is thought to arise in an autosomal dominant fashion.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous Chief Editor, William D. James, MD, to the development and writing of this article.



More on Blue Nevi

Overview: Blue Nevi
Differential Diagnoses & Workup: Blue Nevi
Treatment & Medication: Blue Nevi
Follow-up: Blue Nevi
Multimedia: Blue Nevi
References
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References

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

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  15. 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].

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  17. 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.

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Further Reading

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Keywords

nevus of Jadassohn and Tieche, blue neuronevus, dermal melanocytoma, common blue nevus, cellular blue nevus, chromatophoroma, melanofibroma

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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.

Medical Editor

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.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
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.

Managing Editor

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.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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