Skin-melanocytic tumor
Nevus of Ota

Author: Christopher Hale, M.D. (see Authors page)

Revised: 22 February 2017, last major update November 2014

Copyright: (c) 2003-2017,, Inc.

PubMed Search: nevus of ota
Cite this page: Nevus of Ota. website. Accessed March 21st, 2018.
Definition / general
  • First described by Ota in 1939 (Tokyo Med J 1939;63:1243)
  • Uncommon hamartoma in periorbital and temporal skin (eMedicine - Nevi of Ota and Ito)

  • Types: see also Jpn J Dermatol 1939;46:435
    • Type IA: mild orbital type - distribution over upper and lower eyelids, periocular and temple region
    • Type IB: mild zygomatic type - pigmentation in infrapalpebral fold, nasolabial fold and zygomatic region
    • Type IC: mild forehead type - involvement of forehead alone
    • Type ID: involvement of ala nasi alone
    • Type II: moderate type - distribution over upper and lower eyelids, periocular, zygomatic, cheek and temple regions
    • Type III: involves scalp, forehead, eyebrow and nose
    • Type IV: bilateral
    • Hori’s nevus: acquired bilateral nevus of Ota-like macules (J Am Acad Dermatol 1984;10:961, Dermatol Online J 2005;11:1); usually Chinese women with family history, becomes more confluent and gray over time (Br J Dermatol 2006;154:50)
    • Sun’s nevus: acquired unilateral nevus of Ota
  • Also called oculodermal melanosis or nevus fuscoceruleus ophthalmomaxillaris
  • Similar to nevus of Ito except for location (Ito in shoulder, side of neck and supraclavicular areas, within the distribution of the lateral supraclavicular nerve and lateral cutaneous brachial nerves)
  • Periorbital, temporal
Clinical features
  • Tends to persist and extend locally, becoming increasingly prominent with age, puberty and postmenopausal state
  • Associated with ipsilateral glaucoma, intracranial melanocytosis; rarely with cutaneous, ocular or intracranial melanoma (Cutis 2008;82:25) and vascular nevus (J Am Acad Dermatol 2008;58:88)
  • Macule with irregular blue-gray pigmentation in distribution of 1st and 2nd division of trigeminal nerve
  • May coexist with nevus of Ito
  • Tanino classification system most common, others include Hirayama system and proposed Chan system (Lasers Surg Med 2001;28:267)
Case reports
  • Cosmetic coverup products
  • Multiple sessions of laser photothermolysis to avoid darkening and extension, beginning early after diagnosis (Dermatol Surg 2007;33:455)
  • Subtypes vary in response to laser therapy (Lasers Surg Med 2001;28:267)
  • Combined skin abrasion and carbon dioxide snow method (Plast Reconstr Surg 1996;97:544); cryosurgery and microsurgery not recommended due to scarring; chemical bleaching not recommended due to depigmentation
Clinical images

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Flat blue-gray pigmentation

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Acquired dark brown spots below eyes

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Episcleral involvement

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With nevus of Ito

Microscopic (histologic) description
  • Deeply pigmented dendritic melanocytes and melanophages dissecting bundles of dermal collagen in reticular dermis
Microscopic (histologic) images

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Bipolar dendritic melanocytes in
papillary and reticular dermis

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Wavy dendritic cells with evenly
dispersed melanin granules

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Elongated dendritic melanocytes scattered with collagen bundles extending around hair follicles

Differential diagnosis