Background: Nevus spilus is a rare, acquired, and often large cutaneous lesion consisting of a light brown background macule containing varying numbers of small darker macular or papular areas.
Objective: Nevus spilus may contain dysplastic melanocytic elements, and there are also reports of melanoma arising from nevus spilus. However, the absolute risk for malignant transformation is not well defined.
Conclusion: We discuss a case of synchronous melanomas arising from a nevus spilus and potential management recommendations based on a review of the pertinent literature.