The many faces of blue nevus: a clinicopathologic study.
BACKGROUND
In recent years, several histopathologic variants of blue nevus have been identified, whose clinical and dermoscopic correlates need further clarification.


METHODS
A comparative evaluation of histopathologic and dermoscopic features was carried out on 52 melanocytic proliferations belonging to the morphologic spectrum of blue nevus.


RESULTS
On dermoscopy, all lesions showed a homogeneous, structureless pigment pattern, with a curious variety of colors (blue, white-blue, black, brown, and polychromatic). Histopathologically, the majority of blue lesions were common blue nevi (11/19); the majority of white-blue lesions were 'hypochromic' (sclerotic, hypomelanotic, and amelanotic) blue nevi (17/22); all the black lesions were 'compound' blue nevi (2/2); the majority of brown lesions were combined blue nevi (3/4); the unusual polychromatic dermoscopic appearance was often associated with a histopathologic diagnosis of deep penetrating nevus (2/5).


CONCLUSIONS
A dermoscopic-pathologic approach now allows us to identify 'blue' (common) blue nevi, 'white' (hypochromic) blue nevi, 'black' (compound) blue nevi, 'brown' (combined) blue nevi, and 'polychromatic' (deep penetrating) blue nevi. A better recognition of the many dermoscopic faces of blue nevi is expected to give a morphologic guideline for the clinical management of these lesions.
Ferrara
Gerardo
G
Pathologic Anatomy Service, Gaetano Rummo General Hospital, Benevento, Italy. gerardo.ferrara@libero.it
Soyer
H Peter
HP
Malvehy
Josep
J
Piccolo
Domenico
D
Puig
Susana
S
Sopena
Juan
J
Zalaudek
Iris
I
Argenziano
Giuseppe
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D046169:Dermoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018329:Nevus, Blue / Q000145:classification / Q000473:pathology*; D012878:Skin Neoplasms / Q000145:classification / Q000473:pathology*