- Author: Zoltan Trizna, MD, PhD; Chief Editor: Dirk M Elston, MD more...
Physicians have known for almost a century that some childhood lesions histologically diagnosed as melanomas did not show malignant behavior. The terms juvenile melanoma and prepubertal melanoma were used to describe such lesions.
Several attempts were made to establish objective criteria that would clearly delineate Spitz nevi and melanomas. The controversial classification of some cases as metastasizing Spitz nevi further confounded the issue; however, such cases illustrate the difficulty of accurately distinguishing some Spitz nevi from melanoma based on histological criteria alone. Even today, no set of criteria can be used to predict the clinical outcome of atypical Spitz tumors with absolute assurance.
A Spitz nevus can arise de novo or in association with an existing melanocytic nevus.
Exact data on incidence or prevalence are not available. Spitz nevi are estimated to represent less than 1% of all childhood melanocytic nevi.
Spitz nevi have been described most frequently in fair-skinned individuals. One study reviewed 130 cases in a Hispanic population, demonstrating that Spitz nevi are not restricted to white patients.
Both sexes are equally affected. Some authors describe a slight female predominance.
About 50% of cases occur in children younger than 10 years; 70% of all cases are diagnosed during the first 2 decades of life.
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