NEVUS SPILUS
The nevus spilus (NS) is a cafe-au-lait macule with multiple darker pigmented macules scattered within.
- Onset is congenitally or in childhood.
- If there is no background CALM, the term agminated lentigenosis is used.
- The presence an HRAS point mutation in sporadic nevi spili has been reported suggesting causation.
Clinical
The term NS refers to a pigmented patch that has a light background and multiple, darker pigmented papules or macules within. Larger lesions have been called speckled lentiginous nevus.
Malignant Change
The development of a melanoma within a nevus spilus is a rare event. One review of 25 cases found a mean age of 49 years at melanoma diagnosis. Only 12% (3/25) of the NS were < 4 cm. The following criteria associated with increased risk of developing melanoma:
- Present since birth
- Over 4 cm in diameter
- Giant or zosteriform nevus spilus (> 20 cm).
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