When Pigment Loss Meets Pigment Clusters: Vitiligo in a Congenital Speckled Lentiginous Nevus

Vitiligo, an acquired disorder, manifests as depigmented patches on the skin due to the selective destruction of melanocytes. Congenital speckled lentiginous nevus (CSLN), also known as nevus spilus, is a benign pigmented skin lesion present at birth or appearing early in life. The coexistence of these two conditions is an uncommon phenomenon, and it represents a paradoxical interaction between melanocyte loss and proliferation. Here, we are presenting a case of 11-year-old girl with a nevus spilus over the left-sided upper chest since birth who has now developed a single depigmented patch over the left nipple within the nevus spilus since 2 months. Dermoscopy of the depigmented patch showed a nebuloid pattern, whereas that of nevus spilus showed a fingerprint pattern of the lentigo over a background of reticular pigmentation.