Bilateral nevus of ota with oral mucosal involvement

Introduction

Nevus of Ota, a dermal melanocytic nevus, is common in Japanese.[1] It is comparatively rare in Indian subcontinent. It generally presents as blue - black or gray-brown patchy/diffuse pigmentation that most commnoly occurs unilaterally on face in areas innervated by the first and second divisions of trigeminal nerves.[2] Bilateral involvement can occur, but as a rare manifestation.

This patient has extensive bilateral pigmentation with the involvement of oral mucosa.

Case Report

A 30-year-old woman presented with asymptomatic hyperpigmented macules on face since early childhood. The lesions gradually progressed with age; static since 10-12 years. Cutaneous examination revealed slate- brown hyperpigmented diffuse macules on both the checks, nose and forehead [Figure - 1]. She also had hyperpigmentation of eye-lids, sclera, conjunctiva and hard palate. There was no other associated abnormalities seen.

Discussion

In nevus of Ota (Nevus fuscoceruleus ophthamo-maxillaris) the pigmentation spots usually appear in childhood and the distribution is usually, but not always, unilateral. Open angle glaucoma and malignant melanoma involving the eyes are rare associations reported.[3] This case is being reported for its extensive bilateral and palatal involvement, which is as such uncommonly seen in Indian subcontinent.