Clinical and Histopathology Features of Spitz Nevus: In 22 Cases

Spitz Nevus is an infrequent acquired melanocytic nevus. There is still a challenge for dermatopathologists in distinguishing spitz nevus from malignant melanoma particularly in adults since there is no immunohistochemistry or molecular markers which differentiate Spitz Nevus from melanoma. The aim of this study is to make clear what clinico-histopathological features of Spitz Nevus are in order to reduce malpractice due to misdiagnosis. In the present study, a series of twenty two patients have been reviewed who were diagnosed with Spitz Nevous based on proved histopathology features between the years 2009 - 2013. The patients were evaluated for demographic parameters like age, sex, clinical differential diagnosis, cutaneous location of tumor, tumor diameter, subtype, symmetry, maturation, upper clefting of melanocytic nest, shoulder phenomena, epidermal hyperplasia, type, kamino body, mitotic rate , inflammatory infiltration, pagetoid spread and regression. In our study, 45% of patients were younger than 10 years old. The average age of patients was 14 ± 11.37. Male to female ratio was 1.44. The commonest location was head and neck. Spitz nevus was the first clinical differential diagnosis in 20% of patients. The commonest variant type was conventional type and then polypoid and desmoplastic types. The mean size of nevi was 0.81 ± 0.59 mm. About 59% of nevi shows epithelioid cytologic features. Other histologic parameters from the most to the least frequency were symmetry (100%), maturation (100%), epidermal hyperplasia (77.3%), kamino body (68.2%), subtype (compound 68%), mitotic rate (63.6%), clefting (59%), inflammatory infiltration (54.5%), pagetoid spread (18.2%), shoulder (37.5%) and regression (9.1%). We tried to hifhlight some clinical and histopathological features which are distinguishing Spitz nevus from other melanocytic nevi even malignant melanoma.