|Year : 1985 | Volume
| Issue : 4 | Page : 255-257
Unusual presentations of nevus of ota
KK Bhatia, Surinder Gupta, Ramesh K Narang, Satish Kumar
Department of Skin V.D. Ophthalmology and Pathology Medical College, Rohtak, India
K K Bhatia
Department of Skin V.D. Ophthalmology and Pathology Medical College, Rohtak
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhatia K K, Gupta S, Narang RK, Kumar S. Unusual presentations of nevus of ota. Indian J Ophthalmol 1985;33:255-7
As long back as 1938, Otal, reported an unusual syndrome,. consisting of greyish blue macular discoloration affecting the sclera of one eye and ipsilateral facial skin in the distribution of corresponding trigeminal nerve, under the title, 'Nevus fuscocaeruleus ophthalmomaxillaries'. Jenson and Haffly reported a case with ocular and dermal melanosis under the designation of 'Oculocutaneous melanosis'. Fitzpatrik et al and Cowan et al preferred the term Oculodermal melanocytosis' for such cases. But the term 'Nevus of Ota' is used all over the world as other terms have similarities with a few different clinical conditions. Tanino classified the condition into four types depending upon the severity.
| Case reports|| |
Case 1 : A . young female, 18 years old, presented with complaints of brownish black pigmentation on right side of face. The pigmentation appeared 1˝ years back. It was slowly progressive during the first year. It remained stationary during the last 6 months There was no history of trauma, blistering disorder, conjunctivitis or photosensitivity.
The pigmented macule was present on the right side of the cheek, lower eyelid, and forehead just above the eyebrow. The margins were ill defined with speckled black pigmented spots on brownish background. A few speckled pigmented ]spots were also seen on the skin of nose [Figure - 1][Figure - 2]. Examination of both the eyes revealed bluish brown pigmentation of sclera in the upper medial and upper lateral quadrants just above the limbus. On fundus examination, central and peripheral fields were normal in both the eyes. Family history revealed that her two sisters and one brother had excessive freckling 'while another brother and one sister were free of freckles or such pigmented macules. Histopathological slides from the margin of pigmented patch showed changes of Nevus of Ota.
Case 2 : A 9 year old female complained of slate-grey pigmented patch on left side of face for the last 6 months. It was progressively increasing in size since then. On dermatological examination, there was a slate-grey patch about 2 cm X 6 cm, extending from angle of the left side of mandible to the upper and lower lips on left side. The margins of the patch were ill defined at few places. There were hyperpigmented spots of pinhead size spread over the slate-grey base. Mucus membranes of mouth and nose were normal. Eye examination showed bluishbrown pigmented spots about 3 mm X 3 mm on -sub the upper medial quadrant of sclera just above the limbus on left side only. Fundus examination revealed hyperpigmentation at the medial border of the disc on left side only and normal fundus on right side. The iris and pupil were normal on both sides [Figure 3].
Histopathological report from the margin of lesion showed presence of melanocytes in the upper dermis supporting the clinical diagnosis of Nevus of Ota.
| Discussion|| |
In the first case on correlating the changes in both the eyes with skin lesion on one side, it could not be assigned to any one of the types of Nevus of Ota. According to Tanino only in rare instances, the eye involvement may be bilateral with unilateral skin lesion. This case may be a combination of type ill and type 1V as classified by Tanino.
In this case, there was family history of freckling without any eye changes. Hidano et a1 observed family history of similar lesions in 2 cases Mishima reported association of freckles with Nevus of Ota in one case, which was also seen in this case. Gupta observed the association of Nevus of Ota with mongolian spots on back and arm in one case.
In the second case, the lesion appeared at the age of 8 years. Previous reports suggest the appearance of lesion during infancy or teens, and rarely between the age of one year and teens (Hidano'). In this case, the skin changes were in the distribution of 3rd branch (mandibular) of trigeminal nerve, while other workers have shown its appearance in Ist and 2nd branch of trigeminal nerve (Tanino, Kopf)
So two cases of Nevus of Ota with unusual features are presented.
| Summary|| |
Two cases of Nevus of Ota are presented with the review of literature. In the first case, the eye changes were observed as scleral pigmentation in both the eyes with skin changes in the distribution of Ist and 2nd branches of trigeminal nerve on one side. In the second case, the skin changes were seen in the distribution of 3rd branch of trigeminal nerve with ipsilateral eye changes as scleral and fundal pigmentation.
| References|| |
Ota, M., 1939, Jap. J. Dermat. 46: 369.
Ota, M., Tanino. H., 1939, Tckyo Med J., 63 1243-1244.
Jensen, D. D. F., Haffly, G, N. 1949, Amer. J Ophthalmol, 31 ; 1476.
Fitzpatrick, T. B., Zeller, Kupita, A., Kitamura, H., 1956, AMA. Arch. Ophthalmol, 56 : 830.
Cowan, D. S., Balistocky, M. 1961, Arch. Ophthalmol, 65 :492.
Tanino, H., 1939, Jap. J. Dermat,, 46: 107 and 433.
Hidano, A., Kajima, H., Ikeda, S. et al, 1967., Arch. Derm., 187.195.
Mishima, Y., Mevorah, B., 1961, J. Invest. Derm., 36 : 133.
Gupta, G. P., Gangwar, D. M. 1965, Brit. J. Ophthalmol, 49 : 364.
Kopf. A. W., Weidmar;, A. J. 1962. Arch. Derm., 85 :195.
[Figure - 1], [Figure - 2]