Spitz naevus

What is a Spitz? nevus?

A Spitz naevus (or Spitz nevus) is a rare type of mole (melanocytic nevus).

A Spitz naevus is a benign skin tumor. However, it may look like a evil one melanoma clinically and microscopically, then Spitz naevi they are often removed as a precaution.

Who gets a Spitz naevus?

Spitz naevi are most often seen in children; 70% of cases diagnosed during the first 20 years of life. They can also arise in adults. They are most often found in fair-skinned people (skin phototypes 1 and 2), but can also affect people with dark skin.

What causes a Spitz naevus?

A Spitz nevus is a type of melanocytic nevus, that is, it is a mole made up of melanocytes – these are cells that normally produce pigment, melanin, and are responsible for the color of the skin. Melanocytes in Spitz naevus may be inactive. Therefore, the injury it may be pink instead of brown. the genetic pattern of the DNA in Spitz naevus it is characteristic with kinase fusions being prominent.

It is not known why Spitz nevi occur.

What are the clinical characteristics of a Spitz naevus?

Spitz naevus is classified as classic, pigmentedor spindle cell Reed's tumour.

• The classic Spitz naevus is typically a dome-shaped red, reddish-brown papule.
• A pigmented Spitz naevus is a brown or tan papule or nodule.
• A pigmented Reed spindle cell tumor is a bluish or black papule.

There are clinical features in common for all three types of Spitz nevi.

• Their size varies from a few millimeters to one or two centimeters in diameter.
• They usually appear on the face or extremities.
• Usually a Spitz naevus is solitary, but sometimes they break out as multiple lesions.
• A Spitz naevus grows rapidly for a few months. After the initial growth period, if left untreated, it can remain static for years.
• A Spitz naevus may spontaneously disappear after a while.

the atypical Spitz naevus or spitzoid naevus is so named because its characteristics differ from those seen in most Spitz naevi.

The rare entity, exacerbated Spitz naevus, presents as multiple Spitz naevi in a segmental presentation. It is an example of cutaneous mosaicism and is due to genetics mutation.

How is a Spitz nevus diagnosed?

A Spitz naevus is often clinically suspected because of its characteristic dome-shaped appearance and rapid growth over a few weeks or months.

• Dermoscopy of a classic Spitz nevus often reveals smooth round structures with prominent or rounded punctate. blood vessels.

• A pigmented Spitz nevus may show a starburst or globular pattern of pigmentation but then it evolves into a homogeneous or dermoscopic pattern without structure.
• A typical Reed spindle cell tumor has a deeply pigmented starburst pattern with pseudopods.
• An atypical or spitzoid nevus may have more than one pattern, asymmetry of structure, and unusual dermatoscopic features.

In older children and adults, the diagnosis of Spitz naevus is usually confirmed by excisional skin biopsy. the pathology of Spitz naevus usually shows a symmetrical compound nevus composed of feature nests epithelioid cells in classic and pigmented Spitz, and spindle cells in Reed's spindle cell tumor. Both forms can coexist.

What is the treatment for a Spitz naevus?

In children under 12 years of age, a Spitz naevus can be kept under review by digital dermatoscopic surveillance (monitoring photographs of the dermatoscopic appearance of the lesion). It is expected to spread out evenly for a year or two and then 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 usually excised.

An atypical spitzoid tumor or a spitzoid tumor of uncertain malignant potential (STUMP) may be difficult to distinguish histologically of spitzoid melanoma and is best excised extensively. Sentinel node biopsy should not be performed as the results can be misleading.

What is the result of a Spitz naevus?

If it has not been extirpated, a Spitz naevus can evolve (disappear) in a few years.