SUMMARY
The authors report a case of a conjunctival blue nevus and review the literature pertaining to these pigmented lesions in this location, describing clinical and histological report of a patient with a blue nevus of the palpebral conjunctiva with a literature review. A 64-year-old white female was evaluated for a darkening pigmented lesion of the left lower palpebral conjunctiva. Examination revealed a 3 mm x 6mm blue-black lesion with sharply demarcated edges and an irregular border. Histopa - thology showed plump spindle-shaped, pigmented melanocytic cells revealing a branching network of dendritic processes with small, elongated, and hyperchromatic nuclei consistent with a common blue nevus. No recurrence was noted at 9-month follow-up. Blue nevi of the conjunctiva are lesions that have a low risk for malignant transformation but can appear clinically similar to primary acquired melanosis or melanoma. Blue nevi of the conjunctiva are rare and represent 0.5%-3.0% of pigmented conjunctival lesions. There was one reported case in a literature search of a malignant melanoma arising from a conjunctival cellular blue nevus. Treatment is complete wide excisional biopsy.