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What Is Spitz Nevus?

Clara Kedrek
Clara Kedrek

A spitz nevus is a benign skin growth that is most commonly seen in people less than 20 years old. It is also known by the terms benign juvenile melanoma or epithelioid and spindle-cell nevus. These lesions appear as painless, red, raised areas of skin. Although they are benign and typically don't cause any complications, these spitz nevi can be difficult to differentiate from malignant melanoma, a condition that can be very dangerous. For this reason, these lesions are often removed surgically.

Characteristically, spitz nevi appear as red, raised, circular lesions that have diameters of less than half an inch. Usually they appear as solitary lesions, but occasionally an affected person could have a few of these lesions grouped together. Typically, a spitz nevus does not cause any symptoms, and is generally not painful in any way. They most often occur on the face, neck, shoulders, and arms.

A spitz nevus under the microscope can be very similar to that of malignant melanoma.
A spitz nevus under the microscope can be very similar to that of malignant melanoma.

Young people are typically the only ones who develop spitz nevi. About half of all diagnosed cases are found in patients 10 years old or younger. Although they are more frequently seen in fair-skinned people, they are also fairly common in the Hispanic population. Spitz nevi occur in males and females alike. The reasons why these lesions develop in certain individuals is not well understood; however, it is known that they represent a benign proliferation of a certain type of skin cell called the melanocyte.

Moles may be malignant if they are asymmetrical, have irregular borders, appear to spread their color into surrounding skin or change in appearance.
Moles may be malignant if they are asymmetrical, have irregular borders, appear to spread their color into surrounding skin or change in appearance.

One of the main problems associated with a spitz nevus is diagnosing it. Many other skin lesions such as hemangiomas, malignant melanoma, basal cell carcinomas, moles, and pyogenic granulomas look very similar to spitz nevi. Therefore, a biopsy of the lesion is often performed in order to make sure that it is not a dangerous condition such as a cancer. This, however, is not foolproof because the appearance of a spitz nevus under the microscope can be very similar to that of malignant melanoma. Whereas a spitz nevus is a benign condition that does not cause any complications, malignant melanoma is an aggressive cancer that has a propensity for spreading to distant regions of the body.

A spitz nevus may require removal by a surgeon.
A spitz nevus may require removal by a surgeon.

As it is often difficult to confirm that a lesion is a spitz nevus, and to exclude the fact that it could be a melanoma, these lesions are often removed. Dermatologists or surgeons excise the entire lesion, as well as a margin of skin surrounding the lesion. This skin tissue is evaluated by laboratory studies to see whether any of the lesion invaded into the surrounding area on a microscopic level. Occasionally, some patients have a recurrence of these lesions after the initial removal, and in these cases, the new lesion is once again surgically removed.

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    • A spitz nevus under the microscope can be very similar to that of malignant melanoma.
      By: luchschen_shutter
      A spitz nevus under the microscope can be very similar to that of malignant melanoma.
    • Moles may be malignant if they are asymmetrical, have irregular borders, appear to spread their color into surrounding skin or change in appearance.
      By: bertys30
      Moles may be malignant if they are asymmetrical, have irregular borders, appear to spread their color into surrounding skin or change in appearance.
    • A spitz nevus may require removal by a surgeon.
      By: Nejron Photo
      A spitz nevus may require removal by a surgeon.