Leukotrichia w obrębie znamienia typu nevus pilus współistniejąca z bielactwem

Nevus spilus (also known as speckled lentiginous nevus) is characterized clinically by a light brown macular background, speckled with varying numbers of darker macules or papular lesions. Nevus spilus (NS) may be acquired or congenital. It can affect any part of the body, but the most common locations are the chest and upper limbs [1]. The prevalence of NS varies from 0.2% to 2.3% [2]. The combination of NS with other hypo- or depigmented lesions, such as nevus depigmentosus [3], halo nevus [4], and vitiligo [4, 5], has been observed occasionally.
Here we report the case of a patient who presented with leukotrichia within the lesion of NS and associated with vitiligo. To the best of our knowledge, this is the first report of such presentation.
A 37-year-old male patient presented to our outpatient department with the complaint of a hyperpigmented skin lesion since childhood. However, the patient could not remember the exact time of appearance of the lesion. The patient noticed the appearance of white hairs within the hyperpigmented lesion in the last few years. Recently, the patient had noticed the development of multiple white lesions on the trunk, mostly on the anterior aspect.
Examination of the skin revealed single light brown macule measuring 15 × 9.5 cm on the left side of the anterior abdomen at the level of the umbilicus with multiple small, darkly pigmented macules measuring around 1 × 2 mm, coalescing to form a large macule (fig. 1). Multiple leukotrichia were present only within the hyperpigmented lesion. On the anterior aspect of the trunk multiple hypopigmented macules of varying sizes were present. The patient refused skin biopsy. The patient was counselled regarding the nature of the disease and advised to attend regular follow-up in our outpatient department.
Most authors consider NS as a compound nevus, because it consists of a light brown macular background and specks of darkly pigmented small macules or papules. Nevus spilus shows equal sex distribution and is seen in all races [6]. According to size, NS is categorized into three types: small (< 1.5 cm), medium (1.5–19.9 cm), and giant (> 20 cm) [7]. Usually, NS was considered to be a benign nevus, but for the first time melanoma developing within the NS was reported by Perkinson [8]. The actual contributing factors for the development of NS are still not known, but some genetic and environmental factors seem to play a role [9]. One hypothesis proposed that it is...


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