Think of a Spitz Nevus when you see a mole in a young person that demands your attention.
What are the clinical features?
There are 3 different types of Spitz Nevus, classic, pigmented, or spindle cell tumour of Reed. The colours vary enormously – from light pink to brown or almost black, depending on this type.
They are often raised and resemble a dome-shaped nodule.
A Spitz Nevus can range from a few millimetres to 1-2 centimetres in diameter. They generally appear on the face or limbs.
The growth is usually solitary; however, it is possible to have multiple lesions. They tend to grow quite rapidly and can disappear spontaneously after some time.
Gallery of Spitz Nevus
Please click on the images for details.
A Spitz Nevus does not need to be removed because it is a benign grown (like other moles). However, it is often difficult for a clinician to be certain that the condition is a Spitz Nevus and not something nastier like a melanoma. There is evidence that a low grade of melanoma can overlap with a Spitz Nevus.
For these reasons, the decision for surgical excision of a Spitz should be made by the patient after consultation with the treating doctor. If the growth is not removed, it should be reviewed regularly to ensure it does not develop into anything more serious.
In Australia, a Spitz Nevus is generally removed but again the decision is an individual one and depends on individual factors:
- The appearance of the lesion including dermoscopic findings
- Overall opinion of the doctor
- Consideration of risk with the parents
- National Skin Cancer Professional opinion and/or guidelines
In practice most Spitz are removed to confirm the diagnosis and to avoid any future concerns.
These are some of the key terms that may be used in the Spitz Nevus pathology report
Nests are growths of melanocytes (the benign cells that proliferate in nevi or moles in general).
In Spitz Nevus, the nests form along the junction between the epidermis and dermis.
As The spitz nevus grows larger, the nests extend down into the dermis.
Hyperplastic & Hyperkeratotic Epidermis
The epidermis (upper layer of the skin) is often hyperkeratotic (scaly) & hyperplastic (increased number of cells) – this is also the case with some other types of moles.
Accentuated Granular Layer
The mid layer of the epidermis (upper layer of the skin), called the granular layer, is normally quite a thin layer. In Spitz nevus, this layer is often prominent.
Kamino Bodies are masses that are made up of Basement Membrane and other proteins.