Nevus of Ito

Key Points
Rare type of birthmark which may affected the face (Ota) or shoulder/upper arm (Ito)
Exact cause is unknown, but is due to a buildup of pigment cells in the lower layers of skin
Consists of blue-grey to grey-brown patches of skin

Nevi of Ota & Ito are a rare type of birthmark. Ota typically affects the face, around the eye and forehead, while Ito develops in the shoulder/upper arm. Both conditions consist of hyperpigmented blue-grey to grey-brown patches of skin in the affected area.

Nevi of Ota may develop on one or both sides of the face, and depending on their location, affect the interior of the mouth and/or the eye itself. Additionally, nevi of Ota may grow darker with age up to adulthood, and may change color with a person's environment or physiological circumstance. Rarely, nevi of Ota can cause glaucoma (when it involves the eye), and a slightly increased chance of developing malignant melanoma. Nevi of Ito typically develops on the shoulder/upper arm, usually only on one side. Affected persons may experience changes in sensory perception in the affected area.

The exact cause of nevi of Ota and Ito is unknown, though it is known to be a buildup of pigment cells in the lower layer of skin (dermis). Nevi of Ota, the more common of the two, may appear in adolescence, which suggests a hormonal link. Both conditions typically appear in women, and appear more often in persons of Asian descent, but are extremely rare in other ethnic groups.

Differential Diagnosis (Other conditions with similar appearance)
Blue Nevi
Ochronosis
Lentigo
Phytophotodermatitis
Malignant Melanoma
Melasma
Mongolian spot

Diagnosis
Key Points
Diagnosis based on characteristic appearance of lesions
Skin biopsy may be performed to confirm diagnosis and rule out other conditions
Ophthalmologic testing may be performed if the eye becomes involved

Nevi of Ota & Ito are typically diagnosed based on the characteristic appearance of the lesions, but a skin biopsy may be performed to confirm the diagnosis and to rule out other, similar appearing conditions. Additionally, ophthalmologic testing may be recommended if there is involvement of the eye.

Treatment
Nevi of Ota & Ito typically not treated, as treatment results are not reliable
Health care professionals should be seen regularly in those with eye involvement, and if the nevus changes in any way
OTC Options: cosmetics

Nevi of Ota & Ito are not typically treated. While treatments with laser or IPL therapies may destroy the pigment cells thus lightening the affected area, lesions often recur and may even come back darker. In cases where the eye is involved, regular eye examinations are recommended, as is seeing health care professionals if the nevus should change in any way.