In the past, the nevus spilus was differently interpreted. Ito and Hamada, however, limited this term to a pigmented macule that had darker speckles within it. This newer definition is a useful one in clinical diagnostics. But histopathologically this lesion seems not to be an entity. A review of the literature and the present study suggest that it is in all probability a café-au-lait-nevus of neurofibromatosis-type. The darker spots are different in their histopathologic structures. They are nevus-cell-nevi, nevoid lentigines, epidermal pigmented macules or localized pigment disturbances with melaninincontinence following inflammatory prozesses.