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A nevus spilus is a brown area of skin with darker speckles that can be bumps or flat spots. It is usually present at birth or early in life and is not cancerous, but monitoring is necessary as it can rarely develop into malignant melanoma. There are two types, macular and papular, and it can occur in association with medical disorders. Treatment can be difficult and may leave scars.
A spilus nevus, sometimes known as freckled zosteriform nevus or freckled nevus speckled, is an area of skin that appears brown in color, with darker speckles scattered across it. The size of the nevus can vary, and the speckles can be bumps or flat spots. A nevus spilus can be present on the skin of any part of the body and is usually first noticed at birth or early in life. These skin lesions are not cancerous and can simply be left alone and monitored for any signs of change. Monitoring is done as a precaution because, very rarely, the cells within a nevus spilus can transform and a cancer known as malignant melanoma can develop.
There are thought to be two different types of nevus spilus. In what is referred to as the macular type, the speckles are distributed at fairly even intervals across the nevus and are very flat. What is known as a papular type of lesion has speckles which consist of raised lumps and these are more randomly arranged across the nevus. Although still a rare occurrence, the macular nevus type is thought to be most often associated with the development of malignant melanoma.
Nevus spilus can occur in association with certain medical disorders, such as FACES syndrome. In FACES syndrome, in addition to freckled zosteriform nevi on the skin, there are abnormalities of the eyes and facial features, along with loss of appetite, wasting, weight loss, and fatigue. Phakomatosis pigmentokeratotic is a syndrome in which there is wasting of one side of the body, along with excessive sweating, abnormal sensation, and muscle weakness. In phakomatosis pigmentokeratotica, a nevus spilus develops in association with another lesion known as a sebaceous nevus. The syndrome is very rare, but there is a risk of a malignant change occurring in the skin lesion.
Normally, there are no symptoms of nevus spilus, although a person with a large skin lesion may be concerned about its unsightly appearance. There may also be anxiety about the possibility of developing a malignant melanoma, particularly in the case of a nevus located in a part of the body where it is difficult to see. Any suspicion of malicious changes may require removal. Treatment of nevus spilus is not without problems, because surgery tends to leave scars and the lesion can recur. Therapies using lasers to remove or fade the nevus do not always lead to a satisfactory result.
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