Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
Case Report
1997:63:3;183-185
PMID: 20944318

Malignant blue nevus

SGS Krishnan, Devakar P Yesudian, M Jayaraman, VR Janaki, Patrick Yesudian
 Department of Dermatology, Madras Medical College and Government General Hospital, Madras, India

Correspondence Address:
M Jayaraman
222 R.K. Mutt Road, Mylapore, Madras - 600 004
India
How to cite this article:
Krishnan S, Yesudian DP, Jayaraman M, Janaki V R, Yesudian P. Malignant blue nevus. Indian J Dermatol Venereol Leprol 1997;63:183-185
Copyright: (C)1997 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

Blue nevus represents an aberrant collection of functioning benign dermal melanocytes. Its malignant degeneration is rare and is regarded as a form of malignant melanoma. We report a case of 35-year old male with this rare condition whose primary lesion over left foot ulcerated and patient later succumbed to multiple metastases.
Keywords: Malignant blue nevus

Blue nevus is an area of blue or black dermal pigmentation produced by aberrant collection of functioning benign melanocytes. Blue nevus of skin was described in 1906 by Tieche.[1] Since then it has been reported to occur at other body sites. Three types of blue nevi have been recognised on the skin-common, cellular and combined.[2] Malignant degeneration of these nevi is extremely rare and is regarded as a rare form of malignant melanoma. We report a case of this rare condition.

Case Report

The patient, 35-year-old male, had at birth a circumscribed slightly raised, bluish lesion about 1.5 cm in diameter over the dorsum of the left foot along the medial margin. The lesion had remained silent for 35 years. Recently, for the past 6 months, patient had noticed an increase in size of the lesion along with ulceration [Figure - 1]. Over the past 3 months he had developed bluish pigmented tumor over the tip of the nose [Figure - 2] and multiple bluish black nodules over the thigh. He had associated loss of appetite and weight. On examination he was anemic, emaciated and had multiple enlarged inguinal lymphnodes, which were discrete and firm to hard in consistency.

Biopsy of one of the pigmented nodules of the thigh revealed dense collection of dendritic pigmented cells in the mid and lower dermis. Some of the cells had hyperchromatic bizzare nuclei. A few atypical mitoses were also seen. Overlying upper dermis and epidermis were normal, thus giving a diagnosis of malignant blue nevus [Figure - 3]. Radiography of the chest and bones revealed multiple metastases. Lymph node biopsy was not done. Patient was put on chemotherapy, but died 3 months later.

Discussion

Malignant blue nevus is a rare form of malignant melanoma. It may arise in a blue nevus, nevus of Ota or may be malignant from start. Those arising in a blue nevus occur only in cellular type. The most common site for its occurrence is scalp, even though blue nevi most commonly occur on the dorsum of the hands and feet. Most of the malignant blue nevi at the time of diagnosis are more than 3 cm. in diameter.[3] Metastasis occurs rapidly and lymphnodes are involved invariably. Here we have to be careful to exclude "benign metastasis" where cases of benign cellular blue nevi are associated with regional lymphnode collection of cells histologically similar to the primary lesion.[4] In general, histopathology of the metastases resembles those of the primary lesion except for the difference in the degree of necrosis / cellular pleomorphism.

Our patient had ulceration of the blue nevus which is very rare and has been reported only in 2 cases previously. [5,6] The rapid progression of the disease with multiple metastases early in the course and lack of response to treatment makes it essential to diagnose the condition at the outset. The common occurrence of blue nevus makes it inappropriate to excercise all of them prophylactically, but it would be advisable to remove those greater than 2cm. in diameter.

References
1.
Tieche M. Uber benigne melanome der hant. "blue naevi", Arch Pathol Anat, 1906;186:212-229.
[Google Scholar]
2.
Lever WF, Lever GS. Benign melanocytic tumors and malignant melanoma, In : Histopathology of Skin, 7th edn, JB. Lippincott, Philadelphia 1990;19:712-722.
[Google Scholar]
3.
Goldenhersh MS, Savin RC, Barnhill RL, et al. Malignant blue nevus. A case report and review of the literature, J Am Acad Dermatol 1988;19:712-722.
[Google Scholar]
4.
Allen AC, Spitzs. Malignant melanoma, Cancer 1953;6:1-45.
[Google Scholar]
5.
Jadassohn W, Franceschetti A, Quelques GM. Observations cliniques concernant la pigmentation duderme, Dermatologica 1954;108:225-234.
[Google Scholar]
6.
Herzberg JJ, Klein UE. Blue nevus mit solitar metastasen in lunge and nebennieren, Arch Klin Exp Dermatol 1961;212:158-172.
[Google Scholar]
Show Sections