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Nevus of Ota, which originally was described by Ota and Tanino in 1939, is a hamartoma of dermal melanocytes. Clinically, nevus of Ota presents as a blue or gray patch on the face, which is congenital or acquired and is within the distribution of the ophthalmic and maxillary branches of the trigeminal nerve. The nevus can be unilateral or bilateral, and, in addition to skin, it may involve ocular and oral mucosal surfaces.
Nevus of Ito usually does not have symptoms and causes little cosmetic concern to the patients.
After onset, nevus of Ota may slowly and progressively enlarge and darken in color, and its appearance usually remains stable once adulthood is reached. The color or perception of the color of nevus of Ota may fluctuate according to personal and environmental conditions, such as fatigue, menstruation, insomnia, and cloudy, cold, or hot weather conditions. Nevus of Ota can be associated with other cutaneous disorders and ocular disease. Nevus of Ito can be associated with sensory changes in the involved skin.
Nevus of Ota most frequently presents as blue-to-gray speckled or mottled coalescing macules or patches affecting the forehead, temple, malar area, or periorbital skin. Nevus of Ito presents as a patch on the shoulder or upper arms with blue, gray, or brown pigmentation.
- Most cases of nevus of Ota are unilateral (90%), although pigmentation is present bilaterally in 5-10%. Nevus of Ito usually is unilateral.
- In addition to skin, pigmentation of nevus of Ota may involve oral mucosa and ocular structures such as the sclera, retrobulbar fat, cornea, and retina.
The cause of nevus of Ota and Ito is unknown.
Medical Care
Cosmetic camouflage makeup can minimize the disfiguring facial pigmentation resulting from nevus of Ota. Otherwise, topical therapy is of no value in the medical treatment of nevus of Ota.
Surgical Care
Laser surgery
- Pulsed Q-switched laser surgery is unquestionably the cur1ent treatment of choice for nevus of Ota and Ito, and it works via selective photothermal and photomechanical destruction of dermal melanocytes and melanophages.
- High success rates and minimal adverse effects have been reported with the Q-switched Nd:YAG lasers.
- After 10-20 treatments, skin pigmentation is reduced dramatically or removed in 90-100% of cases, with a less than 1% risk of scarring.
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