Nevus spilus L81.4

Burkley, 1842

A sharply defined, irregularly shaped, usually lentil- to palm-sized, milk-coffee-brown spot with small brown or also black-brown injections (also Kiebitzei nevus), which is already present at birth. The latter often develop only in the course of the first years of life.

Trunk, extremities. 1 case of oral nevus spilus has been reported (Torres KG et al. 2017).

Already present at birth (often overlooked), sharply demarcated, irregularly shaped, usually 0.4-10.0 cm in size, milk coffee-brown spot with small dark brown, spatter-like spots, which often develop only in the course of the first years of life.

In the course of life, the initially rather discrete spatterings may transform into distinctly imprinting black-brown papules, thus giving this nevus variant its typical aspect.

In rare cases the development of malignant melanomas is observed in a nevus spilus. In this respect, the nevus spilus requires regular clinical control.

"Speckled lentiginous nevus" syndrome, is a cutaneous phenotype with nevus spilus (speckled lentiginous nevus) with hyperhidrosis, muscle weakness, dysesthesia or other neurological abnormalities.

Phacomatosis spilorosea (Happle 2005) is characterized by the combination of a nevus spilus with a nevus roseus (=capillary dermal malformation - old term= nevus flammeus).

Phacomatosis pigmentokeratotica (Happle 1996) is characterized by the combination of a nevus spilus with a nevus sebaceus.

The nevus spilus resembles the cafe-au-lait stain, but differs from it in the dark indentations in the underlying brown stain. The term "lapwing egg naevus "describes this aspect very well.

Becker ne vus: This nevus is not congenital, usually develops postpubertally (androgen dependence?) and shows hypertrichosis in addition to a broken reticulated border.

Annual inspection. Excise conspicuous, injected nevi early, as the danger of degeneration cannot be completely negated. If necessary, cosmetic cover with e.g. Dermacolor.

"spilus" = speckled

The lapwing is a bird whose eggs have a conspicuous mottle. The name is most likely derived from these.

1. Breitkopf CB et al (1996) Neoplasms on nevus spilus. Dermatologist 47: 759-762
2. Cramer SF (2001) Speckled lentiginous nevus (nevus spilus): the "roots" of the "melanocytic garden". Arch Dermatol 137: 1654-1655
3. Happle R (2002) Speckled lentiginous nevus syndrome: delineation of a new distinct neurocutaneous phenotype. Eur J Dermatol 12: 133-135.
4. Mang R et al (2003) Unusual clinical presentation of melanocytic nevi. Dermatologist 54: 370-372
5. Ramolia P et al (2009) Speckled lentiginous nevus syndrome associated with musculoskeletal abnormalities. Pediatr Dermatol 26: 298-301
6. Sarin KY et al (2014) Activating HRAS mutation in nevus spilus. J Invest Dermatol 134:1766-1768.
7. Schaffer JV et al (2001) Speckled lentiginous nevus: within the spectrum of congenital melanocytic nevi. Arch Dermatol 137: 172-178
8. Tavoloni Braga JC et al (2014) Early detection of melanoma arising within nevus spilus. J Am Acad Dermatol 70:e31-e32
9. Torres KG et al (2017) Nevus spilus (Speckled Lentiginous Nevus) in the Oral Cavity: Report of a Case and Review of the Literature. Am J Dermatopathol 39:e8-e12.