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Picture of the Month

Philip R. Cohen, MD; Walter W. Tunnessen Jr, MD
Am J Dis Child. 1992;146(9):1095-1096. doi:10.1001/archpedi.1992.02160210097031.
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Denouement and Discussion 

Pigmented Lesions of the Skin 

Nevus Spilus  A nevus spilus is a melanotic patch dotted with darker pigmented speckles. Most commonly, this nevus is a solitary, nonhairy lesion that may occur on any body area. There is no apparent relationship to previous sun exposure. Nevus cells (melanocytes) may be observed in the dermis or the dermoepidermal junction of either the darker or lighter areas of the patch. The presence of nevus cells makes this lesion a melanocytic nevus; therefore, a nevus spilus is histologically different from a cafe-au-lait macule.Cases of nevus spilus occur sporadically. Rare reports of malignant melanoma arising in these lesions suggest that they, like more common melanocytic nevi, should be observed over time for changes that might indicate malignancy.1

Nevus of Ito  A nevus of Ito is a congenital, unilateral, macular pigmented lesion located on skin innervated by the posterior supraclavicular and


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