To the Editor.—
According to Cohen et al,1 we regard nevi spili as congenital melanotic macules with dark maculopapular spots. The clinical follow-up of these lesions has yet to be determined, because there are only a few reports of malignant melanomas arising in nevi spili,2,3 or so-called speckled lentiginous nevi, which we regard as a synonym.Neurofibromatosis is a systemic disease with an elevated risk for developing malignant tumors, most of them from neural crest origin. Silverman et al4 suggested an association between malignant melanoma and neurofibromatosis. We describe a patient with neurofibromatosis and a superficial spreading melanoma on a congenital nevus spilus.
Report of a Case.—
A 50-year-old woman presented with a clinical picture of neurofibromatosis: axillary freckling, neurofibromas, cafe-au-lait spots, and Lisch's nodules. Since birth she had had a large pigmented lesion with dark speckles on the left lower leg (Fig 1). She did not