Nevus of Spitz, an overview of the benign tumour also known as juvenile melanoma

By Cristiano Antonino Last updated Jun 3, 2023

Spitz’s nevus is a benign tumour that affects the skin and usually develops in childhood. The lesion is caused by a proliferation of epithelioid and spindle-shaped melanocytes

Also called juvenile melanoma, Spitz’s nevus affects mainly young individuals, has a rapid, but time-limited growth and a reddish colour.

It is named after Sophie Spitz, the pathologist who first described the disease in 1948.

It has giant cells with little pigment, extending as far as the reticular dermis.

Differentiating it from melanoma is often difficult, but the use of immunohistochemical investigations to find markers such as HMB45 can be useful.

Nevus of Spitz: what is it?

Nevus of Spitz is a melanocytic tumour with a mostly benign course.

Rarely, the transformation occurs in a malignant sense.

The lesion most often appears on the face, lower limbs and trunk, presenting as a pink or red-brownish macula, nodular or dome-shaped, but always uniformly pigmented.

At the beginning the Spitz nevus grows very rapidly, later its size becomes stable.

It has a symmetrical and well-circumscribed shape with a diameter of less than one centimetre.

Difference between Spitz’s nevus and melanoma

Spitz’s nevus is often confused with melanoma because it has a very similar histological appearance.

This is why a differential diagnosis is necessary.

During the dermatological examination and subsequent examinations the Spitz nevus must be distinguished from other pathologies such as molluscum contagiosum, verruca vulgaris, pyogenic granuloma and dermatofibroma.

Therefore, when the lesion is more than one centimetre in diameter, with atypical features or ulcerations, it must be biopsied.

In some cases the doctor may decide to proceed with total excision.

If the patient only has small lesions that remain stable, on the other hand, periodic follow-up and medical evaluation is recommended to monitor possible changes.

Spitz’s nevus: symptoms

Spitz’s nevus occurs on the face, legs or head.

It has a larger growth than other moles with a width ranging from a few millimetres to a centimetre.

The symptoms can be detected with the naked eye.

The Spitz’s nevus is dome-shaped and its colour changes from reddish brown to pinkish.

In some cases it may be colourless, but also black or blue.

The shape changes during growth: usually the nevus is light-coloured and round in shape, later becoming pigmented.

Patients who suffer from it complain of itching around the nevus or on its surface, clearly visible blood vessels, and a scaly, flaky appearance.

Causes

Spitz’s nevus develops due to excessive production and accumulation of melanocytes, the skin cells.

The causes of the development of this formation in some individuals rather than others are not yet clear.

Risk factors include a very fair complexion prone to sunburn, a history of repeated severe burns, fair hair and freckles.

Spitz’s nevus is more frequent in children under ten years of age, who have many moles on their bodies.

Spitz’s nevus: treatment

Spitz’s nevus is removed surgically, but can cause scarring.

Therefore, in cases where the formation is not cancerous, medical monitoring is recommended.

If the lesion is pigmented, symmetrical and less than one centimetre wide, medical monitoring is recommended every six months until it stops growing and changing.

Removal is only carried out if the Spitz nevus has an atypical shape and colour.

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