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| THE CLINICAL PICTURE |
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| Year : 2018 | Volume
: 5
| Issue : 2 | Page : 120-122 |
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Bilateral nevus of Ota
M. M. Aarif Syed1, Bibush Amatya1, Shazia Alam2
1 Department of Dermatology and Venereology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
2 Dr. Agarwal’s Eye Hospital, Cathedral Road, Chennai, Tamil Nadu, India
| Date of Web Publication | 14-Dec-2018 |
Correspondence Address:
Dr. M. M. Aarif Syed
Department of Dermatology and Venereology, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu
Nepal
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/Pigmentinternational.Pigmentinternational_
How to cite this article:
Syed MA, Amatya B, Alam S. Bilateral nevus of Ota. Pigment Int 2018;5:120-2 |
A 22-year-old female presented with darkening of skin of the right side of the face. It was first noticed at the age of three, which was in the form of blue-brown dots over the right cheek. The darkening has been progressive and has taken the present dimensions. On examination, there were bluish to brown coalescing macules involving the right side of forehead, malar region, root, bridge, alae, and dorsum of nose with sparing of the periorbital skin [[Figure 1]a]. The superior and inferior sclera of the right eye, adjacent to the limbus, revealed bluish discoloration [[Figure 1]b]. On examination of the left side of the face, a few scattered brown macules were noted on the alae and dorsum of nose and similarly on the malar region [[Figure 2]a]. The sclera of the left eye [[Figure 2]b] also revealed presence of a few bluish spots which raised the suspicion of the condition being bilateral. On examination of the oral cavity, bluish-grey patches involving both sides of the hard palate were noted [Figure 3]. Hence, a diagnosis of bilateral nevus of Ota was formulated. A clinical image comparing both sides of the face within a closer range helps reveal the bilateral nature of the condition [Figure 4]. | Figure 1: (a) Bluish to brown coalescing macules involving right side of forehead, malar region, root, bridge, alae, and dorsum of nose with sparing of periorbital skin. (b) Superior and inferior sclera of right eye, adjacent to the limbus showing bluish discoloration
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 | Figure 2: (a) A few scattered brown macules on alae and dorsum of left nose and left malar region. (b) A few bluish discolored spots on the sclera of left eye
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 | Figure 4: Bluish to brown coalescing macules involving right side of face with a few scattered brown macules on alae and dorsum of left nose and left malar region. Superior sclera of right eye showing bluish discoloration and a few bluish discolored spots on the sclera of left eye
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Bilateral cases of nevus of Ota are uncommon. The sparse involvement of the contralateral side of the face made our case further unusual. An examination of the oral cavity was crucial to arrive at a conclusive diagnosis. Acquired bilateral nevus of Ota-like macules (ABNOM) or Hori’s nevus was a close differential diagnosis. The two conditions can be differentiated clinically (refer [Table 1]). The patient was requested to undergo a skin biopsy, which was denied. She was counseled about the prognosis and role of laser in treatment, which unfortunately is not available in our center. The patient was further referred for ophthalmic evaluation. | Table 1: Differentiating features of bilateral nevus of Ota and ABNOM/Hori’s nevus
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Nevus of Ota is also known as nevus fusco-ceruleus ophthalmo-maxillaris, because it primarily affects the skin of face adjacent to the eye, distributed along the 1st and 2nd branches of the trigeminal nerve. Sclera is unequivocally involved and hence the synonym “oculodermal melanocytosis.” Ocular complications include glaucoma and melanoma and hence, ophthalmic evaluation is a must.[1] Extracutaneous lesions can be seen in the oral mucosa, which further gives this condition, a third synonym “oculomucodermal melanocytosis.” Skin lesions are permanent and cosmetically worrisome. Laser has been found to be effective; however, availability, cost, and duration of treatment are its limitations. Q-switched Alexandrite laser tends to be more efficient than the Q-switched ND:YAG laser.[2]
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initial will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Junejo MS, Khan MS, Mukhtar A. Ocular features in a case of nevus of Ota. J Coll Physicians Surg Pak 2017;27:S56-7.  |
| 2. | Choi JE, Lee JB, Park KB, Kim BS, Yeo UC, Huh CH et al. A retrospective analysis of the clinical efficacies of Q-switched Alexandrite and Q-switched Nd:YAG lasers in the treatment of nevus of Ota in Korean patients. J Dermatol Treat 2015;26:240-5. |
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1]
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