Mole Spitz Nevus
Spitz nevus, or benign juvenile melanoma, is most common in children, but does appear in adults. The term melanoma is used because the clinical and histologic appearance is similar to melanoma. It most often occurs on the face, scalp or legs of pre-adolescent children. They are hairless, red to reddish-pink, dome-shaped papules or nodules with a smooth or warty surface; they vary in size from 0.3 to 1.5 cm. The color is caused by increased vascularity, and bleeding sometimes follows trauma. Spitz nevi are usually solitary but may be multiple. They appear suddenly and, contrary to slowly evolving common moles, patients can sometimes date their onset. The Spitz nevus should be removed for microscopic examination. Histologic differentiation from melanoma is sometimes difficult. Skin biopsy reveals overall architectural order with nested spindle-shaped nevus cells and areas with large pleomorphic nevus cells. Such changes would be worrisome for melanoma in an adult. The lesion and its biologic course are benign. Most dermatologists favor complete excision of Spitz nevi to minimize the risk of recurrence and associated pleomorphism.