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CASE REPORT
  
Year : 1995  |  Volume : 61  |  Issue : 4  |  Page : 224-225

Speckled lentiginous naevus

Mohan Devinder Thappa, BR Garg, Deepa Bansal, Ratn 
 

Correspondence Address:
Mohan Devinder Thappa


Abstract

20-year-old male had a spotted discoloured area around the nipple of right breast since early childhood. Histopathologically, it was diagnosed as speckled lentiginous naevus and is reported here for its unusual localisation



How to cite this article:
Thappa MD, Garg B R, Bansal D, Ratn. Speckled lentiginous naevus.Indian J Dermatol Venereol Leprol 1995;61:224-225


How to cite this URL:
Thappa MD, Garg B R, Bansal D, Ratn. Speckled lentiginous naevus. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Oct 19 ];61:224-225
Available from: http://www.ijdvl.com/text.asp?1995/61/4/224/4216


Full Text

 Introduction



Naevus spilus or speckled lentiginous naevus is distinctive naevocytic disorder that appears as a circumscribed tan macule dotted by more darkly pigmented raised or flat elements.[1] It ranges in size from less than 1 cm to more than 10 cm in diameter. It usually is an acquired lesion with no sexual predilection. Lesions have been noted primarily on the trunk and extremities, but may occur at any site.[1],[2] We found naevus spilus around the nipple of breast in a 20 year-old-male.

 Case Report



A 20-year-old male had a discoloured area around the nipple of right breast since early childhood. He was not aware of the presence of similar lesion or neurofibromatosis in any member of his family.

On examination, single, oval, well demarcated, light dark brown macule measuring 8 cm in diameter was present around the nipple of right breast [Figure:1]. It was dotted with darker spots, measuring 2 mm to 3 mm in diameter throughout the patch. Hairs, nails and mucous membranes were normal. Rest of the cutaneous and systemic examination was normal.

Hematoxylin and eosin stained multiple sections studied from the skin lesion showed elongation of rete-ridges with increase in the melanocytes and increased pigment in the basal layer. The upper dermis showed nests of neavus cells at places [Figure:2]. A diagnosis of speckled lentiginous naevus was made.

 Discussion



Naevus spilus was originally described as a solitary, hairless, uniformly coloured brown spot. Ito and Hamada[1],[3] however, limited the term naevus spilus to a pigmented macule that had darker speckles within it. Subsequently, Leider and Rosenblum[4] defined the naevus spilus by translating the word spilus as 'spotty'. Thus a transition from 'spot' to 'spots on a spot' took place. Cohen et al[1] reported similar cases with patchy speckled melanotic lesions. The term 'speckled lentiginous naevus' was introduced by Stewart et al[5] to describe this naevoid disorder that is marked by small, dark hyperpigmented speckles superimposed on a tannish-brown background. It was obviously aimed at removing considerable confusion in the literature concerning the term naevus spilus.

A renewed interest in this entity has occurred following the report of 11 cases of malignant melanoma in this previously considered benign naevus,[2] Naevus spilus may be confused with segmental lentiginosis and macular variety of naevomelanocytic naevus. The former is defined by the occurrence of small pigmented macules usually arranged in a segmental distribution, on a normal skin, each macule consisting of a lentiginous proliferation of intraepidermal melanocytes.[2] The latter entity, which is characterised by lightly pigmented macular lesion, in which there are more darkly pigmented neomelanocytic elements and histologic examination will reveal naevomelanocytic naevus throughout. Histologic studies in naevus spilus have demonstrated the flat speckles to consist of lentiginous melanocytic hyperplasia; the raised speckles, collections of naevomelanocytes in the epidermis and/or dermis and the background macule usually demonstrated increased numbers of melanocytes. Occasionally, epithelioid cell-spindle cell naevi have been noted to comprise the speckles of naevus spilus.[2],[5]

References

1Cohen HJ, Minkin W, Frank SB. Nevus spilus. Arch Dermatol 1970;102:433-7.
2Rhodes AR, Mihm MC Jr. Origin of cutaneous melanoma in a congenital dysplastic nevus spilus. Arch Dermatol 1990;126:500-5.
3Ito M, Hamada Y. Nevus spilus en nappe. Tohuku J Exper Med 1952;55:44.
4Leider M, Rosenblum M. A dictionary of dermatological words, terms and phrases. New York : McGraw-Hill, 1968;300.
5Stewart DM, Altman J, Mehregan AH. Speckled lentiginous nevus. Arch Dermatol 1978;114:895-6.

 

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