Clinical, Dermoscopic and Histhopatological Findings in Diagnosis of Nevus Spilus

Abstract

Introduction: Nevus spilus (NS) are seen in 0.2% to 2.3% of the population and have 0,13% to 0,2% risk for malignant transformation. Clinical, dermoscopic, and histhopatological features were describe in this case report in order to be easily recognize NS. Although NS is a benign cutaneous anomaly it has potential malignant transformation and requires regular follow up. Case Report: A case of nevus spilus in 23 years-old female was reported. There were multiple asymptomatic brownish pigmented spots over brownish patch on left cheek which gradually increased in number and size since 1 year ago. Dermatologic state: brown macules and dark brown papules in a speckled, overlying background café au lait macule. Dermoscopy revealed reticular pattern in background light brown and dark reticuloglobular pattern in dark speckled. Histopathology showed elongation of rete ridges with grouping of melanocyte cells at the tip, and proliferation of nevus cells. Conclution: Patient was planned to treat with Nd-Yag laser.

What does dermoscopy tell us about nevus spilus?

“…The histopathology of the spots in NS can range from lentigines, junctional, compound and intradermal nevi to Spitz, blue and neural nevi, while the pigmented background resembles a café au lait macule [13].…”

Dermoscopy as a simple non-invasive tool for diagnosis and monitoring of extensive nevus spilus maculosus

“…Nevus spilus (NS) or speckled lentiginous nevus is a benign melanocytic lesion seen in 0.2-2.3% of the population. [ 1 ] It may be congenital or acquired, and is clinically characterized by multiple pigmented macules or papules of size ranging between 1 and 3 mm in diameter on a background of circumscribed tan macular pigmentation, usually of size between 1 and 10 cm. It is most commonly seen over the trunk and extremities.…”

“…[ 2 ] The histopathology of speckles within the NS may range from lentigines to junctional, compound, and intradermal nevi to Spitz, blue, and neural nevi, while the pigmented background resembles café au lait macule. [ 1 ] In this article, we report a case of large-sized nevus spilus maculosus in a child diagnosed with dermoscopy and histopathology. We have highlighted the role of dermoscopy as a simple, noninvasive tool in diagnosing and monitoring this condition.…”

“…[ 3 ] In atypical cases of NS, dermoscopy may reveal irregular pattern, structureless and hyperpigmented areas which can be biopsied to look for malignant changes. [ 1 ]…”

“…[ 2 ] Hence large, atypical, macular, and changing NS requires self-examination, clinical monitoring, and storage of serial photographs and dermoscopic images for future reference. [ 1 ] Long-term follow-up by digital dermatoscopy and excision of lesions with dynamic changes may help in the early detection of melanoma. [ 4 6 ] Since our case is a NS maculosus involving a larger surface area, frequent clinical and dermoscopic monitoring becomes vital.…”