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Q. My 7-year-old child has recurrent spitz nevus on the left thigh. Please guide me.

Answered by
Dr. Dhepe Snehal Laul
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 21, 2021

Hi doctor,

My 7-year-old child has a spitz nevus on the left thigh. I removed it last year, and it recurred a few months after removal. A purple spot was causing pain, I thought it was scar tissue, but after persistent pain and purple spot, it came back this month, after a year. So removal has been done, and it is sent to the laboratory for the pathology reports. Kindly help me.

Current medications:

Tablet Singulair 10 mg.

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Hello doctor,

Welcome to icliniq.com.

Please tell me when it appeared, is it since birth? Is there any change in shape or size, or diameters noticed? Is there itchy surrounding skin, or is it oozy? Kindly attach a clinical picture to assess the lesion and arrive at a conclusion.

Thank you doctor,

I probably noticed it when she was three years old. It appears as a small dark brown slightly raised spot. It would itch at times, and she would scratch it and make a scab. I was removed before 12 months when she was six years old. Pathology showed spitz nevus. Around three months after removal, a purple spot appeared, and she had pain at the incision site. I just thought it was scar tissue. The spot would be raised at times. It was small, probably 6 mm or less. Finally, after persistent pain and purple spot, he did have itching but no oozing or drainage. I took her to PCP (primary care physician), and he thought regrowth of spitz nevus and removed it again. That was just five days before, and I am waiting on pathology. Should I be concerned about the spread and potential melanoma? I have read some concerning things about spitz nevus. Please help me.

#

Hello,

Welcome back to icliniq.com.

Spitz nevus accounts for 0.5 percent to 1 percent in children. It is also called juvenile Melanoma. Despite having a resemblance to malignant melanoma, it has a benign course. It presents a solitary, pink, dome-shaped, hairless nodule less than 1 cm in size in children and young adults over the face and lower extremities. It is commonly situated on the face and lower extremities, especially in children, sparing the palms, soles, and mucous membranes. Histopathology shows Kamino bodies. Bleeding and crusting may occur because of excessive vascularity. Diascopy demonstrates hyperpigmentation. The lesion grows rapidly at first but later remains static.

Treatment includes local excision with a margin of 1 to 2 mm of normal skin.

Spitz nevi is a rare case. Can you give me the following details?

1) Is there any family history of Melanoma?

2) Is the lesion widespread or localized?

3) Does it have a warty appearance, cluster pattern, or nodule formation?

4) It is present since birth?

5) Does it have large or spreading margins?

6) Does it have an itchy surrounding?

7) Was there any radiation exposure?

Kindly attach the picture to assess the lesion and guide accordingly.

Hello doctor,

Thank you for the help.

I am concerned that the lesion came back, and I waited so long to remove and so It caused her pain. If it is a spitz nevus, do we need not worry further as long as it does not recur again? Do we need to follow up with a dermatologist? The lesion was removed for the second time this week, so no longer there. She still has stitches in. It was localized, and I would say was a small raised nodule. There is no family history of melanoma or radiation exposure. I probably noticed a mole around three years old.

#

Hi,

Welcome back to icliniq.com.

No need to worry. It will not recur as it has benign nature.

1) Is the nodule tender or painful to touch?

2) Does the child cry when you pinch the nodule?

There is no picture attached to assess the lesion properly. Kindly attach a picture to assess the lesion so we can give appropriate treatment.


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