Nevus spilus L81.4

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Lapwing Ineevus; Lapwing-Naevus; Speckled lentiginous nevus

History
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Burkley, 1842

Definition
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Already at birth existing, sharply limited, irregularly shaped, mostly lentil to palm-sized, milky coffee-brown stain with small brown or also black-brown sprinklings (also Kiebitzei-Naevus), which often develop only in the course of the first years of life.

Clinical features
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Already present at birth (often overlooked), sharply defined, irregularly shaped, usually 0.4-10.0 cm large, milky coffee-brown stain with small dark brown, splatter-like spots, which often develop only in the course of the first years of life.

In the course of life, the initially rather discrete spots can change to clearly distinctive 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 monitoring.

Histology
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Partially basal hyperpigmentation as in lentigo simplex, in the dark areas nests of melanocytes as in melanocytic nevi.

Differential diagnosis
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The naevus spilus resembles the cafe-au-lait stain, but differs from it in the darker nodules in the underlying brown stain. The term Lapwing Egg Nevus describes this aspect very well.

Becker-Naevus: This nevus is not congenital, usually develops postpubertal (androgen dependence?) and shows a broken reticulated rim and hypertrichosis.

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

Note(s)
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"spilus" = speckled

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

Literature
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  1. Breitkopf CB et al (1996) New formations 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. Sarin KY et al (2014) Activating HRAS mutation in nevus spilus. J Invest Dermatol 134:1766-1768
  6. Schaffer JV et al (2001) Speckled lentiginous nevus: within the spectrum of congenital melanocytic nevi. Arch Dermatol 137: 172-178
  7. Tavoloni Braga JC et al (2014) Early detection of melanoma arising within nevus spilus. J Am Acad Dermatol 70:e31-e32

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020