Pigmented Lesion - spitz nevus

Diagnosis: Pigmented Lesion - spitz nevus

This is a 17 year old male patient with a benign pigmented lesion that shows spitz nevus on thigh

Clinical Presentation

This is a 17 year old male patient with a benign pigmented lesion that shows spitz nevus on thigh

Clinical History

Submitted by Ellie Goulding MD. Originally posted December 1, 2016.

Treatment

See case discussion.

Differential Diagnosis

• Melanoma • Pyogenic granuloma • Hemangioma • Juvenile xanthogranuloma • Dermatofibroma

Key Learnings

• Benign melanocytic neoplasm — classic: rapidly growing, dome-shaped, pink-red papule in children • Previously called benign juvenile melanoma (Spitz, 1948) — misnomer as it is benign • Can be very difficult to distinguish from melanoma histologically • "Starburst" dermoscopic pattern in pigmented variant is classic • "Atypical Spitz tumor" or "spitzoid tumor of uncertain biologic potential (STUMP)" — controversial category • Sentinel lymph node may be positive in Spitz nevi — does NOT necessarily indicate melanoma • In adults: more concerning for melanoma — excision recommended

Tags: pigmented, lesion, spitz, nevus, ellie goulding md