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Blue Nevis Mole

Description

Blue Nevi are also known as blue moles and are blue-black moles that are common to people of Asian descent. Even if they are present for many years, they are usually benign. They are formed because of a collection of the body’s pigment-producing cells, which are called melanocytes. Any new formation of blue-black lesions needs to be evaluated to rule out a type of melanoma (cancer).

Blue Nevi
Abnormal

Background

There are two variants of the blue nevus whose existences are clinically recognized currently exist. One of these variants is known as common blue nevus and the other variant goes by the name cellular blue nevus. Tieche, a student of Jadassohn, first described the common blue nevus in 1906. This nevus shows itself as a macule, papule, or plaque and has a flat surface or a surface or a surface that is slightly elevated. Its pigmentation can vary from gray-blue to bluish-black color. Lesions usually appear singly and usually appear on the head, pelvic region, and the upper surfaces of both the hands and the feet.

The cellular blue nevus at first was thought to be a variant of melanoma, but it was later reclassified to be a variant of blue nevus. There is still controversy concerning how to determine if an uncharacteristic cellular blue nevus is melanoma. Though the cellular blue nevus is an uncommon lesion, it has characteristics, which are, in a clinical sense, similar to those of the common blue nevus. The lesions are usually rather large, measuring one to three cm. in diameter

Pathophysiology

Blue nevi are believed to represent “dermal arrest in embryonal migration of neural crest melanocytes that fail to reach the epidermis:, although there is no definitive experimental evidence to support this belief. The fetal dermis contains accumulations of melanocytes but they coil or roll in the later stages of pregnancy.

Because of the varied incidences of blue nevi that is found in different populations, it has be suggested that there may be a genetic predisposition which exists, but in documented cases, hereditary cases of blue nevi are found to be rare.

The amount of the melanin that is present in the epidermis combined with the Tyndal effect is the causes of the blue color. What the Tyndal effect comprises is the melanin absorbing favored long wavelengths of light along with the shorter wavelengths being scattered. This in turn, represents the blue end of the spectrum by collagen bundles.

Neither common nor cellular blue nevi is associated with any chromosomal changes and show less B-RAF mutations than congenital and acquired nevi.Frequency

In the United States blue nevi are found most frequently in those of Asian descent where the frequency is likely to be about 3 -5% in adults based on calculated estimates. Among white adults, it is found in approximately 1-2% of the population and is hardly ever seen blacks. Blue nevi are rare at birth or during the infant and toddler stages of life where the frequency is estimated to be less than one case per 1,000 in the population. On an international level, the frequency of blue nevi varies in accordance to the populace examined.

Mortality/Morbidity/Statistics

Most cases of blue nevi remain benign no matter how long they remain and are have no symptoms.

The infrequent cases that are identified of malignant melanoma have usually been associated with cellular blue nevi rather than common blue nevi.More women than men are diagnosed with blue nevi. Most cases of blue nevi are identified in the twenties or later though it may develop at any age.

History

A blue nevus tends to stay the same through life, although sometimes common blue nevi may flatten and its color fade. These changes will evenly distribute through the lesion.

Cellular blue nevi that are malignant may become enlarge and occasionally ulcerate.

Sometimes blue nevi have been identified after a skin trauma including but not limited to sunburn and other similar traumas.

Physical (The footnote for this is for the entire section below)

Blue nevi are best described as smooth-surfaced, dome-shaped papules that slowly develop from a macule to a papule.

Common blue nevi tend to measure less than one cm, but cellular blue nevi are usually larger than one cm.

Though most commonly found on the skin, blue nevi have been found in rare cases in the vagina, the spermatic cord, the uterine cervix, the lymph node, the prostate, the oral mucosa, and the bronchus.

Histologic Findings

There is a histologic continuum that exists between common blue nevi and cellular blue nevi. In common blue nevus there exists a “vaguely nodular collection of poorly melanized spindled melacytes and deeply pigmented dentritic melanocytes within thickened collagen bundles” is visible. In most case, scattered melanophages are noted, but no mitoses are present.


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