Spitz Nevus Treatment & Management

  • Author: Zoltan Trizna, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 3, 2012
 

Surgical Care

Excision of lesions suspected of being Spitz nevi with histopathologic evaluation of the margins of the specimen is indicated.[11, 12]

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Consultations

Consult a plastic surgeon or head and neck surgeon if the excision requires extensive repair.

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Activity

Activity is restricted only to the extent that the surgical procedure justifies.

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Contributor Information and Disclosures
Author

Zoltan Trizna, MD, PhD  Private Practice

Zoltan Trizna, MD, PhD is a member of the following medical societies: American Academy of Dermatology and Texas Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Ronald P Rapini, MD  Josey Professor and Chair, Department of Dermatology, Professor of Pathology, University of Texas Medical School at Houston and MD Anderson Cancer Center

Ronald P Rapini, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Society for Investigative Dermatology, and Texas Medical Association

Disclosure: Elsevier publishers Royalty Independent contractor

Specialty Editor Board

Maureen B Poh-Fitzpatrick, MD  Professor Emerita of Dermatology and Special Lecturer, Columbia University College of Physicians and Surgeons; Professor of Medicine (Dermatology), University of Tennessee Health Science Center College of Medicine

Maureen B Poh-Fitzpatrick, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and New York Academy of Medicine

Disclosure: Lundbeck, Inc. Honoraria Review panel membership; Clinuvel Pharmaceuticals, Ltd. Honoraria Consulting

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD  Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Sepehr A, Chao E, Trefrey B, et al. Long-term Outcome of Spitz-Type Melanocytic Tumors. Arch Dermatol. Oct 2011;147(10):1173-9. [Medline].

  2. Berlingeri-Ramos AC, Morales-Burgos A, Sánchez JL, Nogales EM. Spitz Nevus in a Hispanic Population: A Clinicopathological Study of 130 Cases. Am J Dermatopathol. Jan 22 2010;[Medline].

  3. Rossiello L, Zalaudek I, Ferrara G, Docimo G, Giorgio CM, Argenziano G. Melanoacanthoma simulating pigmented spitz nevus: an unusual dermoscopy pitfall. Dermatol Surg. May 2006;32(5):735-7. [Medline].

  4. Fullen DR, Poynter JN, Lowe L, et al. BRAF and NRAS mutations in spitzoid melanocytic lesions. Mod Pathol. Oct 2006;19(10):1324-32. [Medline].

  5. Gill M, Cohen J, Renwick N, Mones JM, Silvers DN, Celebi JT. Genetic similarities between Spitz nevus and Spitzoid melanoma in children. Cancer. Dec 1 2004;101(11):2636-40. [Medline].

  6. van Dijk MC, Bernsen MR, Ruiter DJ. Analysis of mutations in B-RAF, N-RAS, and H-RAS genes in the differential diagnosis of Spitz nevus and spitzoid melanoma. Am J Surg Pathol. Sep 2005;29(9):1145-51. [Medline].

  7. Da Forno PD, Fletcher A, Pringle JH, Saldanha GS. Understanding spitzoid tumours: new insights from molecular pathology. Br J Dermatol. Jan 2008;158(1):4-14. [Medline].

  8. Egberts F, Kaehler KC, Brasch J, Schwarz T, Cerroni L, Hauschild A. Multiple skin metastases of malignant melanoma with unusual clinical and histopathologic features in an immunosuppressed patient. J Am Acad Dermatol. May 2008;58(5):880-4. [Medline].

  9. Nojavan H, Cribier B, Mehregan DR. [Desmoplastic Spitz nevus: a histopathological review and comparison with desmoplastic melanoma]. Ann Dermatol Venereol. Oct 2009;136(10):689-95. [Medline].

  10. Ko CJ, McNiff JM, Glusac EJ. Melanocytic nevi with features of Spitz nevi and Clark's/dysplastic nevi ("Spark's" nevi). J Cutan Pathol. Oct 2009;36(10):1063-8. [Medline].

  11. Gelbard SN, Tripp JM, Marghoob AA, et al. Management of Spitz nevi: a survey of dermatologists in the United States. J Am Acad Dermatol. Aug 2002;47(2):224-30. [Medline].

  12. Murphy ME, Boyer JD, Stashower ME, Zitelli JA. The surgical management of Spitz nevi. Dermatol Surg. Nov 2002;28(11):1065-9; discussion 1069. [Medline].

  13. Luo S, Sepehr A, Tsao H. Spitz nevi and other Spitzoid lesions part I. Background and diagnoses. J Am Acad Dermatol. Dec 2011;65(6):1073-84. [Medline]. [Full Text].

  14. Boer A, Wolter M, Kneisel L, Kaufmann R. Multiple agminated Spitz nevi arising on a cafe au lait macule: review of the literature with contribution of another case. Pediatr Dermatol. Nov-Dec 2001;18(6):494-7. [Medline].

  15. Dal Pozzo V, Benelli C, Restano L, Gianotti R, Cesana BM. Clinical review of 247 case records of Spitz nevus (epithelioid cell and/or spindle cell nevus). Dermatology. 1997;194(1):20-5. [Medline].

  16. Ferrara G, Argenziano G, Soyer HP, et al. The spectrum of Spitz nevi: a clinicopathologic study of 83 cases. Arch Dermatol. Nov 2005;141(11):1381-7. [Medline].

  17. Harvell JD, Bastian BC, LeBoit PE. Persistent (recurrent) Spitz nevi: a histopathologic, immunohistochemical, and molecular pathologic study of 22 cases. Am J Surg Pathol. May 2002;26(5):654-61. [Medline].

  18. Kapur P, Selim MA, Roy LC, Yegappan M, Weinberg AG, Hoang MP. Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis. Mod Pathol. Feb 2005;18(2):197-204. [Medline].

  19. Orchard DC, Dowling JP, Kelly JW. Spitz naevi misdiagnosed histologically as melanoma: prevalence and clinical profile. Australas J Dermatol. Feb 1997;38(1):12-4. [Medline].

  20. Rapini RP. Spitz nevus or melanoma?. Semin Cutan Med Surg. Mar 1999;18(1):56-63. [Medline].

  21. Shimek CM, Golitz LE. The golden anniversary of the Spitz nevus. Arch Dermatol. Mar 1999;135(3):333-5. [Medline].

  22. Song JY, Kwon JA, Park CJ. A case of Spitz nevus with multiple satellite lesions. J Am Acad Dermatol. Feb 2005;52(2 Suppl 1):48-50. [Medline].

  23. Spatz A, Calonje E, Handfield-Jones S, Barnhill RL. Spitz tumors in children: a grading system for risk stratification. Arch Dermatol. Mar 1999;135(3):282-5. [Medline].

  24. Urso C, Borgognoni L, Saieva C, et al. Sentinel lymph node biopsy in patients with "atypical Spitz tumors." A report on 12 cases. Hum Pathol. Jul 2006;37(7):816-23. [Medline].

  25. Vollmer RT. Patient age in Spitz nevus and malignant melanoma: implication of Bayes rule for differential diagnosis. Am J Clin Pathol. Jun 2004;121(6):872-7. [Medline].

  26. Vollmer RT. Use of Bayes rule and MIB-1 proliferation index to discriminate Spitz nevus from malignant melanoma. Am J Clin Pathol. Oct 2004;122(4):499-505. [Medline].

  27. Weedon D, Little JH. Spindle and epithelioid cell nevi in children and adults. A review of 211 cases of the Spitz nevus. Cancer. Jul 1977;40(1):217-25. [Medline].

  28. Zaenglein AL, Heintz P, Kamino H, Zisblatt M, Orlow SJ. Congenital Spitz nevus clinically mimicking melanoma. J Am Acad Dermatol. Sep 2002;47(3):441-4. [Medline].

  29. Zatterstrom U, Thor A, Nordgren H. Cervical metastasis from Spitz nevus of the buccal mucosa. Melanoma Res. Feb 2008;18(1):36-9. [Medline].

 
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Spitz nevus on the ear of a child.
Microphotograph (low power).
Microphotograph (medium power).
Microphotograph (low power).
Microphotograph (medium power).
 
 
 
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