Unilateral Nevus of Ota with Bilateral Nevus of Ito and Palatal Lesion: A Case Report with a Proposed Clinical Modification of Tanino's Classification
A 24-year-old Indian male patient born out of non-consanguineous marriage, presented with bluish gray asymptomatic mottled pigmented patch on his right side of the face along with bluish discoloration of the upper part of the right eye since his infancy. He also complained of a similar pigmented lesion affecting both of his shoulder regions from his early days of life, though the lesion on the right shoulder started earlier. The discoloration became more prominent with the onset of puberty. He also reported that the intensity of the discoloration of all the lesions aggravates during the summer months. He does not have any complain about his problem except his concern for the cosmetic appearance. On enquiry he told that none of his family members have any such lesion. He did not give history of any major illness including any ophthalmological or auditory complaint.\nOn examination the lesion on the face was found to be distributed on the right side extending from temple to malar and mandibular regions []. Sclera of the ipsilateral side was also involved. He too had a large gray-bluish speckled pigmented lesion on his right and left shoulder regions [Figures and ]. The lesion on the right side was bigger in size and the deltoid and scapular areas were more affected than the supraclavicular region []. Few bluish pigmented patches were also found in the right side of the hard palate [].\nRoutine examinations of the blood, X-ray of the chest and CT scan of the brain revealed no abnormality. Ophthalmologic and ENT examines were normal. Histopathlogic examinations of the skin from the affected area of the face and shoulders showed the presence of heavily pigmented, elongated, dendritic dermal melanocytes. The overlying epidermis was normal.