Melanoma arising in segmental nevus spilus: detection by sequential digital dermatoscopy

Area of Science:

• Dermatology
• Oncology

Background:

• Nevus spilus (NS) is a congenital lesion characterized by a café-au-lait macule with superimposed speckles.
• While the macule is present at birth, speckles develop over time, necessitating vigilant monitoring due to potential melanoma development.

Purpose of the Study:

• To assess the utility of sequential digital dermatoscopy in monitoring adult patients with unilateral segmental nevus spilus.
• To evaluate the potential for early detection of melanoma within NS lesions.

Main Methods:

• Follow-up of 4 adult patients with unilateral segmental NS using sequential digital dermatoscopy and overview images every 6-12 months.
• Mean follow-up duration of 8.15 years.

Main Results:

• Three melanocytic lesions were excised during the study period.
• One patient developed invasive melanoma (Breslow thickness 0.6 mm) detected through monitoring of new pigmented spots and peripheral hyperpigmentation.
• Two dysplastic nevi were excised due to focal enlargement.

Conclusions:

• Sequential digital dermatoscopy is valuable for monitoring adult patients with segmental NS.
• Early detection of melanoma is possible through vigilant follow-up and excision of lesions exhibiting dynamic changes.
• Caution is advised with digital dermatoscopy in children due to physiological changes that may mimic pathological alterations.