A 60-year-old man had consults for an asymptomatic pigmented macule. The dermatological examination had objectived numerous patchy macules of the left arm, varied in color, ranging from light brownish to brown. Dermoscopy revealed a homogeneous reticular pattern consisted of circular macules and homogenous areas, dots, varying in color from light to dark brown, with hypo pigmented areas.

Nevus spilus also know as speckled lentiginous nevus, spots on a spot, and zosteriform lentiginous nevus [1]. It is a rare dermatologic entity, occurring in 2.8% of examined pigmented lesions. It may be congenital or acquired [2]. Nevus Spilus (NS) is clinically characterized by multiple pigmented macules or papules within a pigmented patch (Figure 1).

It is most frequently located on the trunk, the lower and upper extremities, and the head [3]. Dermoscopy of NS reveals darker brown areas with reticular and globular pattern. The bottom is usually clear and brown lattice. In typical cases of NS, dermoscopy is a reticular pattern with no atypia. In suspected cases of atypical NS, it sometimes reveals a hyper pigmented area with an irregular pattern (Figure 2).

Because of the risk of melanoma by transformation, regular skin examination with the use of dermoscopy is strongly recommended.

Conflict of Interest

The authors declare no conflicts of interest.

References

1. Fernandez-Flores A. Eponyms, morphology, and pathogenesis of some less mentioned types of melanocytic nevi. Am J Dermatopathol. 2012; 34(6): 607-618. doi: 10.1097/DAD.0b013e3182476bd6   
2. Kamińska-Winciorek G. Dermoscopy of Nevus Spilus. Dermatologic Surgery. 2013; 39(10): 1550-1554. doi: 10.1111/dsu.12284   
3. Manganoni AM, Pavoni L, Farisoglio C, Sereni E, Calzavara-Pinton P. Report of 27 cases of naevus spilus in 2134 patients with melanoma: is naevus spilus a risk marker of cutaneous melanoma? J Eur Acad Dermatol Venereol. 2012; 26(1): 129-130. doi: 10.1111/j.1468-3083.2011.04030.x