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Nevus spilus, also known as a speckled lentiginous nevus, is a relatively common melanocytic lesion. Most cases  present first as a CALM (cafe-au-lait spot), that gradually develops more pigmented areas over time. The pathogenesis of this lesion is not well understood.

Clinical Features

Nevus spilus may be present at birth, usually as a CALM (cafe-au-lait spot), but may not be evident until childhood.

Cafe-au-lait spot

Months to years after birth, the CALM (cafe-au-lait spot) will develop additional pigmented areas within it, typically 1 to 3 mm in size. The speckles may be flat macular or may be elevated.

It may involve any site of the body.


Nevus spilus is a benign lesion, and no treatment is required.

Once well established, nearly all the lesions remain stable. Although the incidence has not been well studied, atypical (dysplastic) nevi, melanoma in situ, and melanoma have been reported to occur in select cases of nevus spilus. Therefore, the patient should be educated to note any changes in a previously stable nevus spilus and report these changes immediately so that a biopsy can be considered.

Other treatment options have included laser therapy or intense pulsed light therapy.



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