title: Blue nevus with a starburst pattern on dermoscopy.
abstract: An 11-year-old girl presented to our department with a blue-gray papule approximately 4 mm in diameter. We suspected that it was a blue nevus or a pigmented Reed/Spitz nevus. On dermoscopic observation, the lesion showed homogeneous black-bluish pigmentation. This dermoscopic feature was suggestive of a blue nevus. However, near-circumferential streaks and a global feature of a "starburst pattern" were also observed, as is often found in a Reed/Spitz nevus. The lesion was excised and histological examination revealed spindle cells with melanin pigments diffusely present in the upper dermis and around hair follicles in the mid-dermis, but not in the epidermis. The melanocytic cells were arranged in a symmetrical wedge-shaped configuration. In addition, there was a diffuse fibrosis. Finally, we made a diagnosis of a blue nevus based on these findings.
authors.affiliation: Department of Dermatology, Kochi Medical School, Kochi University, Kochi, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Shiga
authors.forename: Kimiko
authors.initials: K
authors.lastname: Nakajima
authors.forename: Masahito
authors.initials: M
authors.lastname: Tarutani
authors.forename: Miki
authors.initials: M
authors.lastname: Izumi
authors.forename: Masaru
authors.initials: M
authors.lastname: Tanaka
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Sano
keywords: Spitz nevus; blue nevus; dermoscopy; histopathology; starburst pattern