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I appreciate Dr Gartmann's additional references from the German-language literature to the cockade like, or target blue nevus. I also agree that this is not a rare finding. I have now observed other cases of this target like pigmentation in blue nevi, and even more cases of cellular blue nevi that possess focal areas that are devoid of pigment.Certainly, a change or loss of pigmentation in blue nevus is an indication for surgical removal, but I think it is most frequently a benign process occurring during the maturation of many blue nevi. Why it so commonly takes a distinctive target pattern on the dorsal aspect of the hands and feet remains a puzzle.
Bondi EE. Target Blue Nevi-Reply. Arch Dermatol. 1987;123(1):18. doi:10.1001/archderm.1987.01660250022002