Atypical Spitz Nevi

Conclusion

This case report underlines the ambiguity and difficulty in diagnosing atypical Spitz nevi, and the clinical management is still a matter of debate. In support of the literature, it may be beneficial to view atypical Spitz nevi as a heterogeneous group of biologically different lesions rather than as a continuum. For example, the lesions can represent a large proportion of morphologically atypical but biologically benign lesions as well as a small group of true melanomas. It is important for dermatologists and plastic surgeons to be aware of atypical Spitz nevi, including pagetoid Spitz nevi, to avoid misdiagnosis and subsequent over- or undertreatment. Rigorous application of the microscopic diagnostic criteria is necessary to aid in the assessment of these lesions. In pediatric patients with atypical Spitz tumors, complete excision with greater clearance and careful follow-up is the management currently recommended.