P. Treadwell et al. (eds.)Atlas of Adolescent Dermatologyhttps://doi.org/10.1007/978-3-030-58634-8_23

23. Nevus of Ota and Ito

Patricia Treadwell¹

(1)

Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA

Patricia Treadwell

Keywords

Nevus of OtaNevus of ItoNevus fuscoceruleus ophthalmomaxillarisNevus fuscoceruleus acromiodeltoideusDermal melanocytosisOculodermal melanocytosis

23.1 Introduction

Nevus of Ota (nevus fuscoceruleus ophthalmomaxillaris) and Ito (nevus fuscoceruleus acromiodeltoideus) are lesions that are examples of dermal melanocytosis. Dermal melanocytosis results from abnormal migration of neural crest cells with subsequent pigmentary changes from the ectopic melanocytes in the dermis.

23.2 Epidemiology

Nevus of Ota and Ito are more common in patients with African or Asian ancestry although they can occur in all races. Females are affected more often than males [1]. There are two peaks of presentation, one at birth, with a second peak near puberty. A few cases of later onset have been reported in the literature [2].

23.3 Clinical Findings

The distribution of pigment in the nevus of Ota typically corresponds to the ophthalmic and maxillary branches of the trigeminal nerve, less commonly corresponding to the mandibular branch. Two-thirds of patients will have ocular pigmentation (oculodermal melanocytosis) (Fig. 23.1). In nevus of Ito, the distribution involves posterior supraclavicular area and lateral neck. In both entities, dermal melanocytosis is responsible for the clinical appearance, with distribution being the main difference between them.

../images/446896_1_En_23_Chapter/446896_1_En_23_Fig1_HTML.jpg — Fig. 23.1
Patient with nevus of Ota. Also has ocular pigmentation

23.4 Laboratory

Histopathology shows pigmented dendritic melanocytes dissecting dermal collagen bundles in the dermis.

23.5 Treatment

A variety of lasers have been used to treat nevus of Ota and Ito [3]. Because of the increased risk of glaucoma in eyes with oculodermal melanocytosis, routine ophthalmologic exams are recommended [3].

23.6 Prognosis

Adolescents without complications such as glaucoma have a good prognosis. Malignant melanoma occurring in the skin, meninges, and/or eye associated with these lesions is quite rare.