Large congenital nevus spilus—improved follow-up through the use of in vivo reflectance confocal microscopy

BACKGROUND Nevus spilus (NS) is a potential precursor of melanoma; the vast majority of cases reported in the literature were histologically classified as superficial spreading melanoma. OBJECTIVE To demonstrate the diagnostic value of reflectance confocal microscopy (RCM) in this subtype of congenital nevi. METHODS We report a case of a large congenital NS with equivocal clinical and dermoscopic findings in which RCM was applied for diagnosis and follow-up. RESULTS There was a good correlation of RCM with histopathology and a lack of dynamic changes during follow-up. CONCLUSION Our observations indicate that RCM, as a non-invasive tool, can be useful for diagnosis and follow-up of clinically and dermoscopically equivocal NS.