Author Affiliations: Department of Internal Medicine and Pediatrics, Division of Dermatology, Washington University School of Medicine and St Louis Children's Hospital, St Louis, Missouri.
Thirty years after presenting as an infant with generalized dermal melanocytosis,1 a patient exhibited bilateral nevus of Ota and hundreds of blue nevi.
A healthy white girl was born with generalized blue patches. Biopsy specimens revealed dermal dendritic melanocytes, consistent with a generalized Mongolian spot.1 By age 15 months, the pigmentation had decreased. However, at age 5 years, she developed widespread bluish, black, and brown macules and papules, especially on her back, extremities, and face. At age 14 years, several biopsy specimens demonstrated histologic findings consistent with blue nevi. During high school and through her early 20s, she used tanning beds and oral contraceptives and developed blue-gray patches over both cheeks, periorbital areas, and forehead.
Diehl JW, Berk DR, Ney A, Bayliss SJ. Diffuse Dermal Melanocytosis: Follow-up 30 Years Later With Novel Findings of Eruptive Blue Nevi. Arch Dermatol. 2011;147(11):1339–1340. doi:10.1001/archdermatol.2011.308