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Blue nevus - Oral Mucosal Lesion
See also in: Overview,Hair and Scalp
Other Resources UpToDate PubMed

Blue nevus - Oral Mucosal Lesion

See also in: Overview,Hair and Scalp
Contributors: Belinda Tan MD, PhD, Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed


The blue nevus, also known as an acquired nevus, is a developmental lesion caused by aggregates of dendritic melanocytes that lie in the deep mucosa. The depth of the pigment creates a "Tyndall effect," which is what makes the melanin pigment appear blue. Although the literature reveals a 2:1 female predilection, this may be related to female patients seeking care more often and having more cosmetic concerns than male patients. It represents approximately one-fifth to one-fourth of all intraoral melanocytic nevi. Most nevi are noticed in the second to fourth decade of life and are usually asymptomatic.


D22.9 – Melanocytic nevi, unspecified

254806009 – Blue nevus of skin

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Differential Diagnosis & Pitfalls

  • Amalgam tattoo may look identical.
  • Graphite tattoo (from pencil lead) may look identical, and the palate is the most common location for this lesion.
  • Melanotic macules are tan to brown rather than blue.
  • A varix may look similar but tends to be more papular and will blanch on pressure.
  • Lobular capillary hemangioma (pyogenic granuloma) tends to be a nodule or papule and is superficially located.
  • Kaposi sarcoma in its very early stage may appear macular or papular, but they rapidly progress to a nodular stage.
  • Melanoma tends to be larger and irregularly pigmented.
  • Melanoacanthoma
  • Mucocele

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Last Updated:12/06/2021
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Patient Information for Blue nevus - Oral Mucosal Lesion
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Blue nevus - Oral Mucosal Lesion
See also in: Overview,Hair and Scalp
A medical illustration showing key findings of Blue nevus : Blue color, Hyperpigmented macule, Pigmented papule
Clinical image of Blue nevus - imageId=75840. Click to open in gallery.  caption: 'A close-up of a smooth, violaceous papule.'
A close-up of a smooth, violaceous papule.
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