[TAG:2]Answer[/TAG:2]

Spitz nevus.

[TAG:2]Discussion[/TAG:2]

Spitz nevus is a benign melanocytic lesion, first described by Sophie Spitz in 1948 as “juvenile melanoma.”^[1] It occurs most often in children or young adults but can occur at any age.^[2] It commonly appears as a solitary, dome shaped, firm, red, or brown nodule,^[3] mainly affecting the face and extremities.^[1] Spitz nevi are generally asymptomatic, but growth can occur over a period of months. The lesions can uncommonly bleed, itch, or be painful.^[2] Differential diagnosis includes melanoma, pyogenic granuloma, verrucae, juvenile xanthogranuloma, dermatofibroma, and hemangioma.^[2]

The hallmark of the pathology of Spitz nevus is the presence of large or spindle melanocytes, usually arranged in nests. The nests are composed of an admixture of spindle and epithelioid cells. Kamino bodies are pale eosinophilic globules, which are commonly found at the dermal-epidermal junction.^[2]

Complete excision with margins free of tumor is the treatment of choice for all Spitz nevi. Spitz nevi with typical features on presentation and biopsy usually are associated with a favorable prognosis,^[4] but it is advisable that patients with atypical lesions have periodic evaluations every 6 to 12 months.

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