Spitz nevus; spindle cell nevus; epithelioid nevus

Introduction

Benign, dome-shaped, hairless nodules < 1 cm in diameter generally pink or tan.

Epidemiology

• 1.4 in 100,000 (Australia)
• occurs at all ages
• rarely seen in individuals > 40 years of age

Pathology

• hyperplasia of epidermis
• neoplasm of melanocytes
• dilatation of capillaries
• large spindle & epithelioid nevus cells
• some cells may be atypical

Clinical manifestations

• papules or nodules, hairless with smooth dome surface
• generally pink or tan, but may be dark brown
• well circumscribed lesions < 1 cm in diameter
• distribution: head & neck
• lesions generally do not involute, but may transform into compound melanocytic nevus or undergo fibrosis & resemble dermatofibroma

Differential diagnosis

• melanoma
• pyogenic granuloma
• hemangioma
• molluscum contagiosum
• juvenile xanthogranuloma
• mastocytoma
• dermatofibroma
• atypical melanocytic nevus
• dermal melanocytic nevus

Management

• excision with border of 5 mm: 10 to 15% recurrence of incompletely excised lesions
• histologic exaination of excised tissue
• follow-up in 6-12 months

More general terms

• melanocytic nevus (mole)