The Blue Nevus

When I saw my primary care physician back in November, she asked me how long I had had that discoloration on my scalp.
I said, “What are you talking about?”
Indeed, there was something there, though neither my wife or I had noticed it. My doctor wanted me to see a dermatologist. Naturally, that takes awhile.
So it was only 10 days ago when I went to the dermatologist, who said, “Ah, you have a blue nevus.”
Now does that not sound like a car or a flower or perhaps something in space?
No, the blue nevus is a variant of a common mole. It is composed of melanocytes, the cells which produce the melanin pigment, which have a spindled to epithelioid appearance. This nevus gets its name from the distinct clinical appearance because of the pigmented cells within the dermis.

So what should I do about it? I noted that my doctor saw it in November but had not seen it in my ptrevious annual visit. Its recent appearance was an issue for my dermatologist; if I had had it for 20 years, he wouldn’t have thought much about it. This not being the case, he said he thought we should have it removed.
I said when should we do that?
He said, “Now, if you’re up for it.”
He numbed the surface with a topical liquid, then gave me a shot (which didn’t hurt), then removed the nevus, needeing three stitches to patch me up. It was a bit more bloody gauze than I would have expected from such a little mole.

I was to come back this past Thursday to remove the stitches and to get the results of the biopsy. I wasn’t worried, since these are almost always benign. On the other hand, in the United States, Blue nevi are most frequently noted in Asian populations, where the prevalence is estimated to be 3-5% in adults. They are found in 1-2% of white adults and are rarely found in blacks.

So I’m atypical. “Blue nevi are twice as common in women than in men.” Also, “Rare cases of malignant melanoma have been reported arising in association with cellular blue nevi.”

I return to the dermatologist as scheduled, got the stitches out and good news about the nevus. The one down side is that it was deep, and it might come back someday, so I may undergo this procedure in the future.


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