Since Burkley first adopted the term Nevus spilus (NS) in 1842, then, many terms have been used as synonyms in the literature to indicate this lesion; speckled nevus: nevus on nevus, naevus sur naevus, spotty nevus, speckled lentiginous nevus, speckled zostriform lentiginous nevus, speckled nevus spilus, cafè au lait spot and partial unilateral lentiginosis.NS refers to a more or less circular shaped lesion, a tan to light brown patch of various sizes and sites, either congenital or acquired and characterized by multiple small darker brown macules superimposed, which can be flat or raised and irregular in nature (Figure 1).The histological patterns of the colored base are those of a simple freckle (macula) or cafè-au-lait patch, whilst the spotted lesions are usually made up of junctional, compound, or intradermal nevi.As a rule, NS is not considered a precursor of melanoma, but more than one case has been reported of melanoma arising in NS [1-31].We will analyze the clinical characteristics and the general evolution of NS and the risk factors of turning malignant.