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Scleral Melanocytosis DD Nevus of Ota and Nevus of Ito but in absence of trigeminal distribution of nevi and the fact that it's bilateral makes the most likely diagnosis is Scleral Melanocytosis
Scleral Melanocytosis , Nevus of Ota was first described by a Japanese dermatologist, M.T. Ota, in 1939 . Histopathology of affected skin shows the presence of dendritic cells containing melanin in the dermis . Ota nevus can be congenital or acquired in adolescence. It occurs almost entirely in persons of Asian descent. Manifestations in fair-skinned non-Asians are very rare . The clinical manifestations are usually unilateral; only 5 percent of cases are bilateral. Clinically, blue-gray macular pigmentation with irregular border involves skin that is innervated by the first and second branches of the trigeminal nerve. Extrancutaneous manifestations include ocular involvement of sclera, episclera, conjunctiva, cornea, retina, and uveal tract. Similar discoloration can be observed in oral mucosa (buccal and palatal), as well as in nasal mucosa and the tympanic membrane. Leptomeninges can also be affected. The occurrence of melanoma has been rarely described .