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Correspondence |

Clinical and Dermoscopic Features of Agminated Blue Nevus

Maria A. Pizzichetta, MD; H. Peter Soyer, MD; Cesare Massone, MD; Lorenzo Cerroni, MD
Arch Dermatol. 2007;143(9):1209-1226. doi:10.1001/archderm.143.9.1225.
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Blue nevi are usually solitary but may rarely appear grouped in an agminated pattern. Clinically, they present as a group of multiple blue nevi in a circumscribed skin area smaller than 10 cm in diameter.1 The skin between the papules may not be discolored and may show a speckled or uniform blue-black or brown pigmentation.1 We report a case of agminated blue nevus.

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Figure 3.

Histopathologic examination revealed a superficial type of blue nevus characterized by a bandlike proliferation of dendritic melanocytes in the superficial dermis. A, Dense, diffuse, bandlike proliferation of dendritic melanocytes in the superficial dermis. Note that there is no junctional involvement at all. An increased melanin pigmentation of the epidermal basal layer can also be seen (hematoxylin-eosin, original magnification ×40). B, Higher magnification reveals morphologic details of numerous dendritic melanocytes and also a few melanophages (hematoxylin-eosin, original magnification × 400). C, Scanning magnification nicely shows that all the dendritic melanocytes are clearly S-100 positive (S-100 staining, original magnification ×40).

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Figure 2.

Dermoscopic image of part of the lesion exhibiting a cluster of blue nevi on the anterior lower extremity on the left leg of a 59-year-old woman. Multiple, grouped, homogeneous, confluent, steel blue to brown-blue pigmented areas fading into the surrounding skin can be seen. On the surface of some steel blue areas, linear pigmented structures appear as darker sulci (diamond). In addition, blue areas, some globules and dots (black arrow), a brown veil (black arrowhead), and brown-blue and out-of-focus pseudopods (white arrows) can be recognized. A small rim of tan pigmentation (asterisk) can also be seen around some blue nevi (original magnification ×10).

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Figure 1.

Clinical image revealing numerous grouped pigmented lesions on the left leg of a 59-year-old woman. A cluster of about 20 blue-brown to slate gray macules and papules of various sizes, some of which were confluent, can be observed (original magnification ×10).

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