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Research Letter |

The Role of Subtractive Color Mixing in the Perception of Blue Nevi and Veins—Beyond the Tyndall Effect ONLINE FIRST

Melissa Shive, MD, MPH1; Derek Ho, BS2; Olivia Lai, BS3; Andrew Mamalis, MS4; Kevin M Miller, MD5; Jared Jagdeo, MD, MS2,4,6
[+] Author Affiliations
1Division of Dermatology, University of California, Los Angeles, Los Angeles
2Dermatology Service, Sacramento VA Medical Center, Mather, California
3Keck School of Medicine, University of Southern California, Los Angeles
4Department of Dermatology, University of California, Davis, Sacramento
5Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles
6SUNY Downstate Medical Center Department of Dermatology, Brooklyn, New York
JAMA Dermatol. Published online July 13, 2016. doi:10.1001/jamadermatol.2016.2201
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This case study examines the visual phenomenon associated with why blue nevi appear blue.

The original study1 that proposed the “Tyndall effect” as the explanation behind the coloration of blue nevi drew from spectrophotometric data on cadaveric skin and not the direct study of blue nevi. Since then, the moniker of the Tyndall effect has been applied to a variety of blue phenomena in the skin despite a lack of confirmatory data. We hypothesized that other light-skin optical characteristics may provide a better explanation for the visual phenomenon associated with why blue nevi appear blue.

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Figure 1.
Reflectance Spectra of Normal Skin, Skin Overlying a Vein, a Normal Nevus, and a Blue Nevus

This graph shows the reflectance of a blue nevus, nevus, normal skin, and a vein across a spectrum of visible light ranging from 400 nm to 700 nm. The blue nevus shows a decreased red light reflectance compared with a normal nevus, and the vein shows a decreased red light reflectance compared with normal skin. Through the concept of subtractive color mixing, this decrease in red light contributes to a perceived blue hue.

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Figure 2.
Image Depicting the Concept of Simultaneous Contrast

This image demonstrates the concept of simultaneous contrast. Both eyes in A and B are exactly the same hue of gray (CMYK 55%, 53%, 48%, 16%). A, When 1 eye is peripherally surrounded by red, that same gray hue appears dramatically blue. B, This illusion is dispelled when the red is removed. Image adapted from Rootman et al.4

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