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Nevus of Ito in Child
Other Resources UpToDate PubMed

Nevus of Ito in Child

Contributors: William M. Lin MD, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed


Nevus of Ito is a unilateral, benign, dermal melanocytosis that presents as a darkly pigmented patch on the side of the neck and shoulder in the distribution of the posterior supraclavicular and lateral cutaneous brachial nerves.

It shares clinical and histopathologic features, aside from location, with other dermal melanocytoses including nevus of Ota (trigeminal distribution), congenital dermal melanocytosis (formerly known as a Mongolian spot in the lumbosacral distribution), and dermal melanocyte hamartoma. Dermal melanocytoses are caused by an increased number of dermal dendritic melanocytes and can be congenital or acquired. All dermal melanocytoses are more often seen in patients of Asian or African descent, and nevus of Ito, in particular, is more common among females.

Unlike the more common congenital dermal melanocytosis, nevus of Ito lesions do not spontaneously regress and may darken or grow in size with puberty. These changes are thought to be secondary to ultraviolet radiation and hormonal influences. Patients have noted sensory changes in the area of the nevus of Ito. Extremely rarely, melanoma arising in a nevus of Ito has been reported.


D22.9 – Melanocytic nevi, unspecified

48543002 – Nevus of Ito

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Differential Diagnosis & Pitfalls

  • Blue-gray spots seen in congenital dermal melanocytosis typically overlie the buttocks or lumbosacral area.
  • Nevus of Ota is characteristically in the trigeminal distribution of the face.
  • Dermal melanocyte hamartoma is extremely rare but can present in a generalized or dermatomal pattern on the extremities or a segmental pattern on the face, neck or trunk.  Histopathologically, pigment is often more superficial than other dermal melanocytoses.
  • Blue nevus may have similar blue to gray pigmentation but is a smaller, well-demarcated macule or papule.
  • Drug-induced pigmentation can either be diffuse or photodistributed.
  • Ecchymoses will have a history of trauma and can have more varied coloration.
  • Arteriovenous malformations can range from blue to red, and pulsations may be heard on Doppler.
  • Becker nevus can be found in a similar distribution but is often tan or brown with coarse hair arising during adolescence.
  • Lentigines (solar, simplex) or giant café au lait macules typically impart a tan to brown hue.
  • Nevus spilus presents with a tan to brown background patch with darker speckled pigmentation within.
  • Melanoma can manifest with disseminated melanosis, but pigmentation will usually be less well-demarcated and will present later in life.

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Last Updated:06/07/2016
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Patient Information for Nevus of Ito in Child
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Contributors: Rachel Lubinga, Chesahna Kindred MD


Nevus of Ito is a pigmented birthmark with a dark brown, blue, or gray color that typically presents on one side on the upper body.

It commonly presents at birth, but it can also appear during puberty or pregnancy, due to hormonal changes. It can become darker after puberty and remains permanent thereafter.

Nevus of Ito is mostly asymptomatic but can rarely be associated with a loss of sensation in the affected areas.

Patients are usually able to live a normal life with this lesion with no medical treatment necessary.

It is benign, but exceedingly rarely, melanoma may develop within nevus of Ito.

Who’s At Risk

Nevus of Ito is most commonly seen in individuals of Asian or African descent. It appears more frequently in women.

Signs & Symptoms

Nevus of Ito presents as a dark brown, blue, or gray patch unilaterally on the shoulder, upper chest, or back. The lesion can be small or cover the entire upper extremity and shoulder.

Self-Care Guidelines

  • There is no recommended over-the-counter treatment to use for nevus of Ito.
  • Makeup can be applied over the patch for cosmetic purposes.
  • Examine the affected area to look for new or changing lesions, and visit a dermatologist if any changes are seen.

When to Seek Medical Care

If you have a nevus of Ito, it is important to schedule visits with your dermatologist periodically. If you notice any changes within nevus of Ito, you should consult your dermatologist for a physical examination. The physician will decide if the lesion needs further investigation to rule out malignancy.


Nevus of Ito does not require medical therapy. However, if these lesions are cosmetically bothersome, your physician may:
  • Use lasers, specifically a pulsed quality switched (Q-switched) laser that targets melanocytes, therefore decreasing the skin's pigmentation.
  • A biopsy may be recommended if the physician wants to further investigate your diagnosis under a microscope. Usually, a punch biopsy is done so that multiple layers of the skin can be observed.
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Nevus of Ito in Child
A medical illustration showing key findings of Nevus of Ito : Blue color, Hyperpigmented patch, Shoulder, Speckled configuration, Supraclavicular fossa
Clinical image of Nevus of Ito - imageId=915383. Click to open in gallery.  caption: 'A large brown-gray patch on the upper back.'
A large brown-gray patch on the upper back.
Copyright © 2023 VisualDx®. All rights reserved.