A nevus spilus is a compound lesion consisting of a cafe-au-lait macule, with numerous junctional nevi within. These junctional lesions are typically darker and are somewhat raised.
The junctional areas should be judged with the same criteria as nevi with any other melanocytic lesion in terms of atypia and cancer risk.
The background cafe-au-lait lesion seems to have no significant malignant potential. The malignant potential of small nevus spili is very low.
- No treatment is required, although the patient should be advised of the morphologic alterations that would indicate a worrisome change, as in any other melanocytic lesion.
- Highly atypical lesions can be surgically removed.
- Each junctional "nevus" within the nevus spilus should be viewed as an individual lesion, and evaluated separately.