What is spitz nevus

Spitz naevus used to be called juvenile melanoma, but it's not really accurate to call it this. Melanoma is a type of skin cancer. It develops from skin cells called melanocytes. Melanoma can occur in children, but it is extremely rare. Unfortunately, in a small number of cases, Spitz naevi can look so much like melanoma that it can be almost impossible even for an expert to tell the difference. If it is impossible to tell if you have a Spitz naevus or a melanoma, your specialist will recommend the lesion is sent for a second opinion.

Because of this, doctors often remove a Spitz naevus together with a border of healthy tissue around it. This is so that a specialist can examine the whole of it under a microscope in a laboratory. Certain people are more at risk of developing melanoma. Our advice to everyone, children and adults, is to cover up and stay in the shade.

If you must go into the sun, wear a high factor sunscreen - such as SPF For an adult, you need about 7 teaspoonfuls to cover yourself completely. Obviously, this is only a rough guide.

Magi, L. Mazzoni, G. Pellacani, et al. Evolution of Spitz nevi: a dermoscopic and confocal follow-up of 26 cases. Emiroglu, P. Biyik Ozkaya, A. Su, N. Scalvenzi, S.

Staibano, B. Brunetti, D. Piccolo, M. Delfino, et al. Dermatoscopic pitfalls in differentiating pigmented Spitz naevi from cutaneous melanomas. Moscarella, A. Lallas, A. Kyrgidis, G. Ferrara, C. Longo, M. Scalvenzi, et al. Clinical and dermoscopic features of atypical Spitz tumors: a multicenter, retrospective, case-control study.

Semin Cutan Med Surg. Peters, J. Spitz naevi and malignant melanomas of childhood and adolescence. Menezes, W. Surg Pathol Clin. Kamino, T. Flotte, E. Misheloff, M.

Greco, A. New findings and a diagnostic sign. Spatz, E. Calonje, S. Handfield-Jones, R. Spitz tumors in children: a grading system for risk stratification. On the nature of histologic observations: the case of the Spitz nevus.

Gambini, F. Recurrent Spitz nevus. Case report and review of the literature. Harvell, B. Bastian, P. Persistent recurrent Spitz nevi: a histopathologic, immunohistochemical, and molecular pathologic atudy of 22 cases. Am J Surg Pathol. Busam, R. Pagetoid Spitz nevus. Intraepidermal Spitz tumor with prominent pagetoid spread. Fernandez, S. Billings, W. Bergfeld, J.

Ko, M. Pagetoid Spitz nevi: clinicopathologic characterization of a series of 12 cases. Burg, W. Kempf, M. Huwyler, R. Ziemer, C. Diaz-Cascajo, G. Valdivielso-Ramos, A. Burdaspal, E. Conde, P. Hyalinizing spindle and epithelioid cell nevus. Mihm Jr, C. Plexiform spindle cell naevus: a distinctive variant of plexiform melanocytic naevus.

Fabrizi, G. Polypoid Spitz naevus: the benign counterpart of polypoid malignant melanoma. Diaz-Cascajo, S. Borghi, W. Angiomatoid Spitz nevus: a distinct variant of desmoplastic Spitz nevus with prominent vasculature. Kapur, M.

Selim, L. Roy, M. Yegappan, A. Weinberg, M. Use the Bayes rule and MIB-1 proliferation index to discriminate Spitz nevus from malignant melanoma. Am J Clin Pathol. Bergman, R. Dromi, H. Trau, I. Cohen, C. The pattern of HMB antibody staining in compound Spitz nevi. Kanter-Lewensohn, M. Hedblad, J. Wejde, O. Immunohistochemical markers for distinguishing Spitz nevi from malignant melanomas. Garrido-Ruiz, L. Requena, P. Ortiz, B. Alonso, J. The immunohistochemical profile of Spitz nevi and conventional non-Spitzoid melanomas: a baseline study.

Pita, S. Kantrow, V. Goncharuk, H. Diwan, et al. Spitzoid melanoma in children: clinicopathological study and application of immunohistochemistry as an adjunct diagnostic tool.

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Dermatol Clin, 31 , pp. Yazdan, C. Cooper, L. Sholl, K. Busam, A. Rademaker, B. Weitner, et al. Comparative analysis of atypical spitz tumors with heterozygous versus homozygous 9p21 deletions for clinical outcomes, histomorphology, BRAF mutation, and p16 expression. A diagnostic algorithm for atypical spitzoid tumors: guidelines for immunohistochemical and molecular assessment.

King, S. Porchia, K. Differentiating spitzoid melanomas from Spitz nevi through CD99 expression. Bergam, H. Azzam, E. Sprecher, L. Manov, M. Munichor, R. Friedman-Birnbaum, et al. A comparative immunohistochemical study of MART-1 expression in Spitz nevi, ordinary melanocytic nevi, and malignant melanomas.

J Am Acad Dermatol, 42 , pp. Rode, R. Williams, L. Jarvis, A. Dhillon, O. S protein, neurone specific enolase, and nuclear DNA content in Spitz naevus. J Pathol. SA6 protein expression is different in Spitz nevi and melanomas. FD Medline. Subscribe to our newsletter. See more. Recommended articles. Part Torus Palatinus. Instructions for authors Submit an article Ethics in publishing. Article options. Are you a health professional able to prescribe or dispense drugs?

Face, neck, and extremities. Well-defined and regular. Poorly-defined and irregular. Irregular, ulcerated. Juvenile xanthogranuloma. Molluscum contagiosum. Amelanotic melanoma. Pigmented Spitz nevus. Congenital and acquired melanocytic nevus. Desmoplastic Spitz Nevus. Multiple Spitz Nevi. Metastatic melanoma. Starburst pattern. Central pigmentation with homogeneous greyish, blueish, and black color with regular radial projections streaks or pseudopods at the periphery.

Globular pattern. Central blue-black pigmentation and presence of regularly distributed round or oval structures of brown-black color at the periphery. Homogeneous pattern. Diffuse, brown, grey-blue, or grey-black pigmentation in the absence of other structures. Atypical or multicomponent pattern. Uneven distribution of colors and structures.

Reticular pattern. Pigment network similar to that present in acquired melanocytic nevi. Reticular depigmentation. Network of hypopigmentation white lines surrounding pigmented globules. Punctiform vascular pattern. Dotted vessels with regular distribution. Glomerular vascular pattern. Tortuous or coiled capillaries. Vascular pattern with hairpin vessels. Looped or bending vessels. Vascular starburst pattern. Regular radial vascular lines at the periphery.

Homogeneous pinkish color. Pinkish tone with or without remnants of brownish pigmentation in absence of other structures. Whitish network surrounding the vessels. Chrysalis structures. Linear, orthogonal, or disordered lines of bright white color. Well delimited. Poorly delimited. Intact or hyperplastic epidermis. The atypical Spitz naevus or spitzoid naevus is so called because its features differ from those seen in the majority of Spitz naevi.

The rare entity, agminated Spitz naevus, presents as multiple Spitz naevi in a segmental presentation. It is an example of cutaneous mosaicism and is due to a genetic mutation. A Spitz naevus is often suspected clinically by its characteristic dome-shaped appearance and rapid growth over a few weeks to months.

In older children and adults, the diagnosis of Spitz naevus is usually confirmed by an excisional skin biopsy. The pathology of Spitz naevus usually shows a symmetrical compound naevus composed of nests of characteristic epithelioid cells in classic and pigmented Spitz, and fusiform cells in spindle cell tumour of Reed. Both forms can co-exist. In children under the age of 12 years, a Spitz naevus may be kept under review using digital dermatoscopic surveillance monitoring photographs of the lesion's dermatoscopic appearance.

It is expected to enlarge uniformly over a year or two and then to stop growing. Because of the difficulty in definitively predicting the outcome of Spitz naevi in older children or adults, or if the structure of the lesion is not uniform, they are generally excised. An atypical Spitzoid tumour or a spitzoid tumour of uncertain malignant potential STUMP may be difficult to distinguish histologically from spitzoid melanoma and is best widely excised. Sentinel node biopsy should not be undertaken as the results can be misleading.

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