Blue Nevi Clinical Presentation

Updated: Sep 18, 2020
  • Author: Rudolf R Roth, MD; Chief Editor: William D James, MD  more...
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Once a blue nevus appears, it tends to remain unchanged throughout life. Occasionally, common blue nevi flatten and fade in color. These changes are evenly distributed throughout the lesion.

Malignant change in cellular blue nevi may be heralded by a sudden increase in size and occasionally ulceration.

Cases of eruptive blue nevi have been reported, some following skin trauma, such as sunburn.


Physical Examination

Blue nevi are usually smooth-surfaced, dome-shaped papules that slowly develop from a macule to a papule. [9]

Common blue nevi tend to be smaller than 1 cm, and cellular blue nevi tend to be larger than 1 cm.

Blue nevi are most commonly found on the skin. Rare cases of common blue nevi have been reported in the vagina, the spermatic cord, the uterine cervix, the lymph node, the prostate, the oral mucosa, and the bronchus. [10]

See the images below.

Common blue nevus on the scalp. Common blue nevus on the scalp.
Common blue nevus on the hand. Common blue nevus on the hand.


Common blue nevi are clinically benign. Lesions tend to persist unchanged throughout life.

Cellular blue nevi are usually clinically benign. Because of their large size, biopsy and excision tend to be performed more often on cellular blue nevi than on common blue nevi.

Rare cases of malignant melanoma have been reported to arise in cellular blue nevi. Any change in these lesions is an indication for biopsy or excision.