Spitz Nevus (Mole): How It Looks and When to Remove One
Medically reviewed by Brendan Camp, MDMedically reviewed by Brendan Camp, MDA Spitz nevus is an uncommon type of mole that is usually raised, dome-shaped, and pigmented. Anyone can have a Spitz nevus, or multiple, but they’re more common in children and people with fair skin.A Spitz nevus isn’t cancerous. However, some Spitz nevi (the plural of Spitz nevus) have atypical characteristics that make them look suspiciously like melanoma, a type of skin cancer, and are therefore often removed as a precaution. This article discusses what Spitz nevi and atypical Spitz nevi look like, how they are similar to and different from melanoma, and when it may be preferable or necessary to have a Spitz nevus removed.
Reproduced with permission from © DermNet dermnetnz.org 2023.
What Spitz Nevus Typically Looks LikeA Spitz nevus is a noncancerous mole that often appears on the legs, face, or neck but can also occur on the trunk or arms. Spitz nevi usually appear as only one lesion, but they can also develop as multiple lesions.Although they can appear at any age, Spitz nevi often appear in childhood, usually within the first 20 years of life. They tend to appear suddenly, grow quickly in a few months, then stop growing and may even disappear after a period of time.A Spitz nevus typically has the following characteristics:SymmetricalCircularFirmSmooth or warty surfaceUp to 1 centimeter in diameterDome-shaped Red, red-brown, pink, blue-black, tan in color or the same color as the skin
Spitz Nevus in Children vs. AdultsThe color of Spitz nevi in children ranges from skin color, pink, red, to brown, but it’s often reddish. The reddish color is due to there being little melanin (skin pigment) and a lot of blood vessels in the area. Spitz nevi can range in color across different people, but the Spitz nevus itself is usually the same color throughout. In adults, a Spitz nevus is usually darker in color, somewhere between brown and black.Where the Spitz nevus develops is often different for children and adults. For example, in children, Spitz nevi usually show up on the head or neck, whereas in young adults, they usually show up on the legs.
Some Spitz nevi may bleed, ooze, or itch. However, most people with a Spitz nevus don’t have symptoms.A Spitz nevus can look a lot like melanoma, a serious type of skin cancer, and a dermatologist may need to look at it using a dermoscope (or dermatoscope), a noninvasive magnifying tool for skin lesions, and take a skin biopsy (removing a sample of tissue for analysis in a lab) to make sure it isn’t melanoma.
What Causes Spitz Nevi and Who Gets ThemExperts don’t know what exactly causes a Spitz nevus. Melanocytes—the cells that make the skin pigment, melanin—are thought to be inactive in a Spitz nevus. People of all skin tones can get a Spitz nevus, but it’s more common in people with fair skin.Spitz nevi affect both males and females, though females between the ages of 15 and 30 may be more likely to get them, which is thought to be associated with hormones.
Characteristics of Atypical Spitz NevusAtypical Spitz nevi are different from most Spitz nevi and have the following characteristics:AsymmetryLarger than 1 cm in diameterBroken on the surface (ulcerated)Different colors or patternsIt's important to see a primary care provider or a dermatologist (specialist in conditions of the skin, hair, and nails) if you see atypical features of a Spitz nevus or mole. A provider can determine whether ongoing monitoring or treatment such as surgical removal is necessary.Spitz Nevus and Cancer: What's the Connection?A Spitz nevus isn’t skin cancer. However, because it’s difficult to know what a Spitz nevus will do over time, especially if it has atypical characteristics resembling melanoma, it’s usually taken out.Spitz Nevus and Melanoma: Overlaps and DifferencesAn atypical Spitz nevus may also be referred to as an atypical Spitz tumor. While “tumor” is in the name, it doesn’t necessarily mean it’s cancerous. Atypical Spitz tumors share characteristics with a Spitz nevus but have some microscopic features that are associated with melanoma. The potential of atypical Spitz nevi to be malignant (cancerous) is controversial. It can be hard to tell an atypical Spitz tumor apart from spitzoid melanoma, even under a microscope, which has led experts to recommend that they be removed as a precaution. When to Consider Spitz Nevus RemovalThe first step in considering whether to remove a Spitz nevus is having it looked at by a dermatologist. They may use a dermoscope to examine the Spitz nevus and take a biopsy if it looks suspicious. A biopsy can help determine if it’s benign (noncancerous) or malignant. Even if your Spitz nevus is benign, you may still want it removed for cosmetic reasons. Talk to a health care provider or dermatologist if you have questions about Spitz nevus removal.Purpose of Dermoscopylike Spitz nevi, up close. Under the dermoscope, they can evaluate the color, structure, and patterns of skin lesions to help diagnose certain skin conditions, like atypical moles and melanoma. Dermoscopy may also be used to monitor a Spitz nevus and see if and how it changes over time. Dermoscopy is a useful technique to inform dermatologists whether a skin biopsy is necessary.Healing After Spitz Nevus RemovalIf your Spitz nevus is removed, your dermatologist will provide you with aftercare instructions. Make sure to follow these instructions to give your skin the best chance at successful and speedy healing. If you have stitches, your provider will let you know when you need to return to get them removed. Generally speaking, taking care of your skin after removal of a skin lesion includes:Making sure your hands are clean when you care for the affected area of skinKeeping the wound from reopening Using ointments, if directed by your dermatologistBe sure to tell your healthcare provider if the skin lesion returns after the wound has healed.SummaryA Spitz nevus is an uncommon type of mole that is fast-growing. It’s more common in children and people with fair skin but can develop on anybody. Spitz nevi are not cancerous, but some have atypical features that make them look like melanoma and are often removed as a precaution. A dermatologist will use a dermoscope to examine a Spitz nevus and take a biopsy if they see something suspicious. Read the original article on Verywell Health.
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