Dermal melanocyte hamartoma (dermal melanocytosis) is a very rare condition characterized by areas of diffuse gray-blue pigmentation or coalescing macular lesions, present at birth, and with similarities to the nevi of Ota and Ito. Differential diagnosis of these dermal melanocytic lesions include the Mongolian spot, the blue nevus, the nevus of Ota, the nevus of Ito and dermal melanocytic harmatoma. The 15-years-old girl visited our clinic for hyperpigmented patches on the left thigh. It present at birth, show multiple brownish macule on the diffuse gray-blue pigementation base. Nevus spilus is also known as speckled lentiginous nevus because it has spotted apperarance with background light brown discoloration. They are thougt to be a form of congenital nevi because they usually appear at birth or soon thereafter. Combined nevus of a nevus spilus and a dermal melanocytic lesion are unusual, to our knowledge, the combination of nevus spilus and an overlying dermal melanocyte hamartoma has not been previously reported.