Spitz nevus
Spitz nevus
SpecialtyOncology, Dermatology
Prognosisbenign

A Spitz nevus is a benign skin lesion. A type of melanocytic nevus, it affects the epidermis and dermis.[1]

It is also known as an epithelioid and spindle-cell nevus,[2] and misleadingly as a benign juvenile melanoma,[2]:โ€Š691โ€Š and Spitz's juvenile melanoma[3]). The name juvenile melanoma is generally no longer used as it is neither a melanoma, nor does it occur only in children.[4]

Pathophysiology

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Micrograph of a Spitz nevus showing the characteristic vertically arranged nests of cells ("hanging bananas"). H&E stain.

The cause of Spitz nevi is not yet known. There is an association with sunburn, but causation is not established.[1] Genetic studies of Spitz nevi have shown that most cells have the normal number of chromosomes, however a minority (25%) of cells have been shown to contain extra copies of parts of some chromosomes, such as the short arm of chromosome 11 (11p).[1]

Diagnosis

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Various differential diagnoses of pigmented skin lesions, by relative incidence and malignancy potential, including "Spitz, Reed or spindle nevus" at top right.

On histopathology, Spitz nevi characteristically have vertically arranged nests of nevus cells that have both a spindled and an epithelioid morphology. Apoptotic cells may be seen at the dermoepidermal junction. The main histologic differential diagnoses are pigmented spindle cell nevus and melanoma.

Treatment

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Surgical removal is usually performed, even though it is benign.[citation needed]

Epidemiology

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Spitz nevi are uncommon. Their annual incidence was estimated in a coastal population of sub-tropical Queensland to be 1.4 cases per 100,000 people. For comparison, the annual incidence of melanoma in the same population, which is high by world standards[5] is 25.4 cases per 100,000 people.[4]

Although they are most commonly found on people in their first two decades of life,[1] the age range for people with Spitz nevi is from 6 months to 71 years, with a mean age of 22 years and a median age of 19 years.[4]

Eponym

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The lesion is named after Sophie Spitz, the pathologist who originally described it in 1948.[6]

See also

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References

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  1. ^ a b c d LeBoit, PE, Burg G, Weedon D, Sarasin A. (Eds) World Health Organization Classification of Tumours: Pathology and Genetics of Skin Tumours. Lyon: IARCPress. 2006.
  2. ^ a b James, William D.; Berger, Timothy G.; etย al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBNย 0-7216-2921-0.
  3. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp.ย 1728โ€“30. ISBNย 978-1-4160-2999-1.
  4. ^ a b c Crotty, K. Spitz Naevus: Histological features and distinction from malignant melanoma. Australasian Journal of Dermatology. 38 (suppl): S49-S53. 1997.
  5. ^ Ries LAG, et al., eds. SEER Cancer Statistics Review, 1975โ€“2000. Bethesda, MD: National Cancer Institute; 2003: Tables XVI-1-9.
  6. ^ Spitz S. Melanomas of childhood. Am. J. Pathol.1948;24:591-609.
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Melanocytic nevus

A melanocytic nevus (also known as nevocytic nevus, nevus-cell nevus, and commonly as a mole) is a usually noncancerous condition of pigment-producing

Melanoma with features of a Spitz nevus

of a Spitz nevus, also known as a Spitzoid melanoma, is a cutaneous condition characterized histologically with tissue similar to a spitz nevus and with

List of skin conditions

of Spitz nevus) Pseudomelanoma (recurrent melanocytic nevus, recurrent nevus) PUVA lentigines Small-sized congenital nevocytic nevus Spitz nevus (benign

Small-cell melanoma

hyperchromatic nuclei and prominent nucleoli. Melanoma with features of a Spitz nevus List of cutaneous conditions Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo

Melanoma

membranes. Desmoplastic melanoma Melanoma with small nevus-like cells Melanoma with features of a Spitz nevus Uveal melanoma Vaginal melanoma Polypoid melanoma

Pigmented spindle cell nevus

in 1975. Partial unilateral lentiginosis List of cutaneous conditions Spitz nevus Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology:

Spitz (disambiguation)

by PepsiCo All pages with titles beginning with Spitz All pages with titles containing Spitz Spitz nevus, a skin lesion Spitzer (bullet) This disambiguation