Nevus of Ota, also known as nevus fuscoceruleus ophthalmomaxillaris, is a pigmentary change involving the first and second divisions of the trigeminal nerve. It is usually unilateral, meaning that it generally involves only one side of the face over the cheek, nose, forehead, temple and around the eye. However it can be bilateral (both sides of the face) about 5% of the time. It is seen as an area of irregular blue, bluish-gray or brown pigmentation and often the person will also have a bluish discoloration involving the covering of the eye (conjunctiva), the cornea (clear part of the eye) and the retina (the inside lining of the eye). Roughly half of the cases of Nevus of Ota are present at birth. The rest develop after birth generally during the teenage years. The pigmentation can develop over time, in other words, these lesions can develop incrementally not all at once.
The Nevus of Ito, also known as nevus fuscoceruleus acromiodeltoideus, is very similar to Nevus of Ota in appearance and presentation. It differs in that the pigmentation is not on the face area. Instead it tends to be seen on the shoulders, upper arms, axilla (arm pits), deltoids and sides of the neck. This distribution of pigment corresponds with the skin innervation of the posterior supraclavicular and lateral cutaneous brachial nerves.
Both the Nevus of Ota and Nevus of Ito develop in the skin distribution of specific nerves as noted above. They can be treated with lasers to improve their appearance however the results are not always uniform and scarring can be a complication. Otherwise the lesions will remain unchanged throughout life. However they can darken with sun exposure. They are most commonly seen in Asians and Blacks. Both are benign however malignant melanoma can rarely occur within these areas.
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