Case Study : Dermatology

108. Benign Blue Nevus

Gratefully sourced with permission from Photo Rounds in The Journal of Family Practice

108. Dark mole on face

A 19-year-old woman presented to her family physician (FP) with a dark mole on her face.

She said that the mole had been there for more than 5 years, but indicated that it had been getting darker.

She was worried that it might be skin cancer and wanted it removed.

The physician noted a 4-mm darkly pigmented, slightly raised lesion.

The patient denied any personal or family history of skin cancer.

Benign Blue Nevus


The physician suspected that this was a benign blue nevus because it had a regular border and was uniformly dark in color. He also recognized that melanoma is very rare at age 19. That said, it is hard to ignore a changing mole that is so black in color.

The patient wanted it removed, so a 5-mm punch biopsy was performed. 

When the punch core was removed, the physician noted that the pigment was visible in the deep dermis (as expected with a blue nevus).

A single suture was placed, and the patient was scheduled for follow-up in one week. The pathology report came back as a blue nevus, which is completely benign.

While many blue nevi actually appear blue because of the Tyndall effect causing the dark melanin in the deep dermis to create a blue coloration, some will appear black (as was seen in this case).

On the follow-up visit, the suture was removed and the incision was healing well. The patient was reassured that this was a benign mole and was happy with the cosmetic result.


Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD.

This case was adapted from: Smith M, Usatine R. Benign nevi. In: Usatine R, Smith M, Mayeaux EJ, et al.

Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:945-952

Copyright  © 2018 Frontline Medical Communications Inc., Parsippany, NJ, USA. All rights reserved. Unauthorized use prohibited.The information provided is for educational purposes only. Use of this Web site is subject to the medical disclaimer and privacy policy.

Ireland notes.png

CPD Quiz and Certificate

This activity attracts 0,5 CPD point

108. benign blue nevus.jpg

Scroll down the box above to view its entire content

All users who successfully complete the quiz are e-mailed a copy of their personalised CPD certificate.