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Blue nevus - Oral Mucosal Lesion
See also in: Overview,Hair and Scalp
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Blue nevus - Oral Mucosal Lesion

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

Synopsis

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 1/5 to 1/4 of all intraoral melanocytic nevi. Most nevi are noticed in the 2nd to 4th decade of life and are usually asymptomatic.

Codes

ICD10CM:
D22.9 – Melanocytic nevi, unspecified

SNOMEDCT:
254806009 – Blue nevus of skin

Look For

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Diagnostic Pearls

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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

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 10/31/2017
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Blue nevus - Oral Mucosal Lesion
See also in: Overview,Hair and Scalp
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Blue nevus : Blue color, Hyperpigmented macule, Pigmented papule
Clinical image of Blue nevus
A close-up of a smooth, violaceous papule.
Copyright © 2019 VisualDx®. All rights reserved.