Skin-melanocytic tumor
Nevi
Nevus of Ota

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

Revised: 22 February 2017, last major update November 2014

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

PubMed Search: nevus of ota
Cite this page: Nevus of Ota. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumormelanocyticotasnevus.html. Accessed March 28th, 2017.
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
Terminology
  • 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)
Epidemiology
Sites
  • 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
Treatment
  • 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

Micro Description
  • Deeply pigmented dendritic melanocytes and melanophages dissecting bundles of dermal collagen in reticular dermis
Micro 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