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April 1990

Origin of Cutaneous Melanoma in a Congenital Dysplastic Nevus Spilus

Author Affiliations

From the Department of Dermatology, University of Pittsburgh (Pa) School of Medicine (Dr Rhodes), and the Department of Pathology, Harvard Medical School, Boston, Mass (Dr Mihm).

Arch Dermatol. 1990;126(4):500-505. doi:10.1001/archderm.1990.01670280084015

• Cutaneous melanoma developed in contiguity with a congenital nevus spilus on the leg of a 79-year-old white woman. The unique features of the nevus spilus in this case were its relatively large size (diameter, 8 cm), irregular gross appearance, lifelong stability until the recent appearance of a tumor nodule, and the presence of intraepidermal melanocytic dysplasia appearing as multifocal elements within darkly pigmented speckles distributed throughout a lightly pigmented background of lentigo simplex. Based on this observation, we suggest that the presence of intraepidermal melanocytic dysplasia in nevus spilus may be a predisposing factor for the development of melanoma. The malignant potential of "dysplastic" nevus spilus requires further study.

(Arch Dermatol. 1990;126:500-505)