Nevus spitz: A review of the literature and clinical cases from practice

Nevus Spitz (juvenile melanoma) is a rare type of melanocytic nevi that mimics skin melanoma by clinical and histological manifestations. The article discusses the issues of diagnostics and tactics of management of spitcoid formations, an analysis of 27 cases from our own prac-tice. The detection rate of Spitz nevus with mixed dermatological admission was 1.8%. The age of the majority of patients did not exceed 18 years; the average was 14.7±14.5 years. The most common site for Spitz’s nevus was the skin of the extremities. Dermatoscopic examination revealed a globular model of the structure in 40.8% of cases, a vascular model — in 22.2%, homogeneous and radial radiance — in 18.5% each. Existing dermatoscopic algorithms for evaluating melanocytic formations including computer analysis using an artificial neural network turned out to be ineffective in determining the correct treatment tactics. The results of the combined use of the ABCD dermatoscopic rule and the Moleanalyzer Pro algorithm coincided with the doctor’s recommendation in 38.5% of cases. Only 50% of patients appeared for a fol-low-up examination for dynamic observation of the Spitz nevus. The cases in which surgical treatment was recommended were statistically different in the patient’s age and the size of the formation from these indicators in the patients of the observation group (p