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19-Year-Old Female with Blue-Black Nodule Near Left Eye

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

A blue-black nodule has been present next to a 19-year-old woman’s left eye since birth. After recent accidental trauma, the lesion has enlarged.

What does this look like to you?

Choose one to reveal diagnosis and discussion

Nevus of Ota
Cellular blue nevus
Combined nevus
Spitz nevus
Melanoma

Answer: Cellular blue nevus

See the full case at Consultant360

The biopsy confirmed a benign cellular blue nevus. These nevi are evenly colored gray, bluish, or black and have symmetric, smooth borders. Congenital or acquired, single or multiple blue nevi can arise at any location. Although they are benign, these congenital lesions occasionally can be invasive. Increased endocrine activity is not associated with these nevi. A nevus of Ota is a gray or bluish macule that involves the eye. Combined nevi generally possess features of blue nevi and of compound nevi, with one of the lesions layered atop the other. These usually thicker nevi are typically darker brown to black, symmetric, and have smooth borders; they can be found anywhere on the body. Spitz nevi usually are pink, brownish red, or purplish red lesions of less than 10 mm. Melanoma is always a concern; this patient’s nevus resembled a nodular variant of skin cancer. The biopsy ruled out a malignancy.