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Spitz nevus; spindle cell nevus; epithelioid nevus
Benign, dome-shaped, hairless nodules < 1 cm in diameter generally pink or tan.
Pathology:
1) hyperplasia of epidermis
2) neoplasm of melanocytes
3) dilatation of capillaries
4) large spindle & epithelioid nevus cells
5) some cells may be atypical
Epidemiology:
1) 1.4 in 100,000 (Australia)
2) occurs at all ages
3) rarely seen in individuals > 40 years of age
Clinical manifestations:
1) papules or nodules, hairless with smooth dome surface
2) generally pink or tan, but may be dark brown
3) well circumscribed lesions < 1 cm in diameter
4) distribution: head & neck
5) lesions generally do not involute, but may transform into compound melanocytic nevus or undergo fibrosis & resemble dermatofibroma
Differential diagnosis:
1) melanoma
2) pyogenic granuloma
3) hemangioma
4) molluscum contagiosum
5) juvenile xanthogranuloma
6) mastocytoma
7) dermatofibroma
8) atypical melanocytic nevus
9) dermal melanocytic nevus
Management:
1) excision with border of 5 mm: 10 to 15% recurrence of incompletely excised lesions
2) histologic exaination of excised tissue
3) follow-up in 6-12 months
General
melanocytic nevus (mole)
References
Color Atlas and Synopsis of Clinical Dermatology, Common
and Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY,
1997, pg 142-44