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.
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.