What Is Spitz Nevus?
A Spitz nevus appears as a pink papule with a flat or dome-shaped top. These bumps are uniform and clearly defined. Typically, they are small (less than 6 mm) or large (1 cm in diameter or more). These lesions are usually single, but it is also possible for them to appear in groups. Usually, they are pink in color but can also be red, brown, black, or brown/black lesions; the skin's surface can occasionally become ulcerated or scabbed. Sometimes, it may also itch, bleed, or be uncomfortable.
What Is the Incidence of Spitz Nevus?
Spitz nevi affect around half to two-thirds of people under the age of 20. As age increases, this lesion becomes less prevalent and is more likely to be detected as melanoma. The percentage of pigmented Spitz moles is considered to be approximately ten percent.
The cause of its origin is not yet determined, although it might appear in conjunction with a pre-existing nevus. Congenital Spitz marks a higher preference in females and Caucasians with light skin.
What Is the Epidemiology of Spitz Nevus?
Spitz tumors are most commonly found in individuals between 10 to 20 years old, although they can occur in children of any age. Adult spitzoid proliferations are uncommon.
Data on the risk factors for spitzoid proliferation is scarce. The risk factors for conventional melanoma (for example, ultraviolet [UV] radiation exposure; light skin phenotypic; a high number of typical nevi; atypical nevi; large, congenital nevi; and genetic susceptibility) do not appear to be essential for Spitz tumors.
Where Does Spitz Nevus Occur?
Spitz nevi are a kind of skin growth that frequently appears on the head, face, neck, or anywhere on the body. Spitz nevi in children occur on the head and neck and in adults on the limbs. They are usually asymptomatic but can enlarge over time.
How Is Spitz Nevus Diagnosed?
Depending on histopathological criteria, Spitz lesions can be classified into three types:
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Spitz lesions with no atypical characteristics.
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Spitz lesions with melanoma-like (malignant) features.
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Malignant melanoma.
Pathologic investigation always confirms the diagnosis of Spitz nevus. These lesions are commonly misdiagnosed, and the diagnosis is also determined after light microscopy. If Spitz nevus is detected, an excisional biopsy is preferable.
What Is a Compound Melanocytic Nevus With Features of Atypical and Spitz Nevus?
Atypical Spitz nevi are skin moles that histologically characterize both benign Spitz nevi and malignant melanomas. Compound nevi are benign skin cell proliferation at the epidermal-dermal interface. Although it is commonly found in all age groups, an increase in the number of nevi increases the chance of acquiring melanoma.
Atypical Spitz tumors include the following features:
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Greater than 1 cm in width.
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Ill-defined edges.
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Uneven, varied tonality.
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Scaly, gritty, or crusty.
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Open gaping sores or fissures.
How Often Is Spitz Nevus Misdiagnosed?
Incorrect diagnoses of the Spitz nevus are frequently made based on the clinical appearance. As a result, even though Spitz lesions are easily distinguished, they can challenge current light microscopy that has historically been used to discriminate between malignant and nonmalignant lesions.
Some commonly misdiagnosed clinical conditions are listed below:
How to Remove a Spitz Nevus?
Most medical professionals advise taking a biopsy of each Spitz nevus.
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The majority agreed that Spitz nevi should be entirely removed. There is no consensus on therapy beyond surgical excision of the local lesion with a 1 mm to 2 mm margin.
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Atypical Spitz lesions indicate one-centimeter-wide excisional margins.
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In children under the age of 12 with a starburst-a pattern of Spitz nevus, if there are no aggravating traits or conditions, it has been suggested that a thorough clinical follow-up without the need to remove these lesions is sufficient.
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The treatment of melanoma having Spitz-like characteristics is wide excision following the depth of the lesion, as well as nonsurgical therapy if judged suitable.
Why Do They Cut So Deep for Spitz Nevus?
All the skin around the lesion must be excised, from the dermis to the mid or deep subcutaneous fat. Half or partial excision may hide pathogenic characteristics that distinguish it from atypical nevi or melanoma. Each case should be reviewed individually for its conditions when the biopsy is done to minimize overtreatment, especially in young children.
Immediately consult a physician if having a mole that shows the following signs,
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Greater than 6 mm.
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Wide and leaks or bleeds.
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An uneven border that itches or hurts.
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Unsymmetrical.
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Appears odd from many other moles on the body.
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Spreads to other locations.
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Produces redness or swelling beyond its bounds.
What Is the Prognosis of Spitz Nevus?
The prognosis of Spitz nevus is favorable, and re-excision should be used to treat recurrences. According to a 2011 study of 157 patients with Spitz-type melanocytic lesions, atypical Spitz tumors pose a low risk of death but have an increased risk of melanoma and a moderate probability of spreading to regional nodes. Although aggressive treatment is usually unnecessary, it is advisable to keep an eye out for signals of relapse as well as subsequent melanomas. Mitoses and inflammation are both signs of increased aggression. The use of single morphologic characteristics to predict prognosis has significant limits.
Conclusion
In case of any doubts about a mole on the child's body, get it examined. A person should visit a doctor to get a Spitz nevus evaluated. Although this mole is most likely benign, it can be misdiagnosed as melanoma. Thus, it is crucial to receive a proper diagnosis. The doctor may opt to keep an eye on the area to monitor the changes or may need to partially or fully remove the mole. Feel free to discuss an appropriate course of action for the specific circumstance with the doctor.
