It is perfectly natural to feel anxious when you notice a new spot or a bump on your little one’s skin. When it looks a bit unusual, it’s common to wonder, “What could this be?” One condition that often comes up in this situation is what doctors call a Spitz Nevus.
What is a Spitz Nevus?
Simply put, a Spitz Nevus is a benign, or non-cancerous, mole-like growth. They are most commonly found in children. Typically, it appears as a raised, pinkish bump. However, they can sometimes be flat, rough, or appear in colors like blue, black, or brown. Doctors sometimes refer to these as an Epithelioid Nevus or a Spindle-cell Nevus.
Seeing a Spitz Nevus on your child can be worrying because it may sometimes look similar to (Melanoma), a serious type of skin cancer. However, the best news is that Spitz Nevi (the plural of Spitz Nevus) are not skin cancer.
While a Spitz Nevus is rarely a cause for alarm, it is vitally important to see a healthcare professional to get an accurate diagnosis. Many children with a Spitz Nevus do not require any treatment. However, if your child’s Spitz Nevus begins to change in shape or size, your doctor may decide it is best to have it removed.
What is the meaning behind the name?
A Spitz Nevus is a medical term for a specific type of birthmark.
- Spitz: This name honors Dr. Sophie Spitz, an American pathologist who studied these specific skin growths in children in the late 1940s.
- Nevus: This is the medical term for a mole. Moles are formed when melanocytes—the cells that provide skin color—cluster together, causing a localized change in pigment.
How common are Spitz Nevi?
Many people have common moles, often referred to as acquired moles, which can appear at any stage of life. In fact, individuals with fair skin may have up to 40 common moles.
However, Spitz Nevi are very rare. They account for only about 1% of all moles removed and biopsied via surgery.
What causes a Spitz Nevus?
Medical experts are not entirely certain about the exact cause of Spitz Nevi. It is believed that certain genetic mutations may increase the likelihood of these moles developing in some individuals.
Who is at risk of developing them?
Moles can develop on anyone regardless of age, gender, or skin tone. However, those with fair skin have a higher probability of developing Spitz Nevi. Most Spitz Nevi are considered acquired moles, meaning they appear after birth.
Spitz Nevi can emerge at any point in life. Roughly speaking, cases are distributed across different age groups:
- Before age 10.
- Between ages 10 and 20.
- After age 20.
In very rare instances, a Spitz Nevus may be present at birth, which we refer to as a congenital birthmark.
What does a Spitz Nevus look like?
A Spitz Nevus usually appears as a pink or red raised bump. They can also be flat and range in color from tan, brown, or orange-brown to black.
While most people have only one, they can occasionally appear in clusters.
Common characteristics of Spitz Nevi include:
- They may resemble a wart.
- They may grow slowly over several months, reaching up to a centimeter (about half an inch) in diameter.
- They may occasionally ooze, bleed, or itch.
- Over several years, they may shrink or flatten, sometimes disappearing entirely.
What does childhood melanoma look like?
In truth, childhood melanoma is extremely rare. Even in the United States, there are fewer than 400 cases of childhood melanoma reported annually. However, if a child does develop melanoma, it can often resemble a Spitz Nevus, which is why parents may be concerned.
Signs of melanoma can include:
- A raised appearance, similar to a bump or wart.
- A growth that appears suddenly and grows and changes rapidly.
- Uniform color, usually red, pink, purple, or flesh-toned.
- An itching sensation.
- Bleeding, healing, and then beginning to bleed again (recurring).
Most importantly: If you notice a new spot or bump on your child's skin, it is difficult for you to determine whether it is a Spitz Nevus or melanoma. Therefore, see a dermatology specialist (Dermatologist) immediately.
Where do Spitz Nevi usually appear?
A Spitz Nevus can appear anywhere on the body, but they are most common on:
- The face
- The neck
- The trunk (abdomen)
- The arms
- The legs
How are Spitz Nevi diagnosed?
If you notice a new bump, spot, or any changes to an existing mole on yourself or your child, you must consult a dermatologist. This is crucial because a Spitz Nevus and melanoma can look very similar.
Your doctor will examine the growth and ask when you first noticed it or if it has changed recently. They may also perform the following tests:
- Dermoscopy: Using a specialized magnifying lens (dermatoscope), the doctor will closely examine the mole for irregularities.
- Mole mapping: This involves using a camera with a dermatoscopic lens to monitor changes in shape, size, and color over time. This helps in tracking any evolution of the mole.
- Skin biopsy: A skin biopsy is the only way to confirm if a mole is cancerous. Your dermatologist will remove a small tissue sample of the mole to be sent to a lab to check for signs of malignancy.
How are Spitz Nevi treated?
Many people with Spitz Nevi do not require any treatment. However, your doctor may suggest annual skin checks or mole mapping to ensure the lesion remains stable.
In the following situations, your dermatologist may decide to surgically remove the Spitz Nevus along with a small margin of surrounding skin and tissue:
- If the mole is asymmetrical in shape or displays an irregular pattern.
- If it bleeds, oozes fluid, or becomes itchy.
- If the diameter is larger than 1 centimeter (half an inch).
Can you prevent a Spitz Nevus?
The exact cause of these moles is currently unknown. There is no specific way to prevent a Spitz Nevus from appearing on you or your child.
How can you prevent skin cancer?
Skin cancer is a risk for everyone. You can take the following steps to protect your skin from sun damage:
- Apply a broad-spectrum sunscreen with at least SPF 30 every single day – even when you are indoors.
- Avoid using tanning beds or sunlamps.
- Try to perform outdoor activities before 10 AM or after 4 PM, when the sun's rays are less intense.
- If you must be outdoors during peak hours, always seek shade.
- Wear sun-protective clothing, including a wide-brimmed hat and large sunglasses.
How can you identify abnormal skin changes?
It is important to regularly check your own skin and your children's skin for any changes in moles or patches. If there is a family history of skin cancer, doctors recommend performing a self-examination at least once a month. You can also take photos of existing moles to help track any subtle changes over time.
The ABCDE rule is a helpful tool for identifying potential skin concerns. Keep an eye out for these signs:
- A – Asymmetry: Check if the mole is asymmetrical or irregular (meaning if you divide it in half, the two sides do not match).
- B – Borders: Look for blurred, jagged, or rough edges.
- C – Colors: Look for a mix of colors such as brown, black, red, or blue. (Keep in mind that childhood melanoma often presents as a single color—typically red, pink, purple, or skin-toned).
- D – Diameter: Check if it is larger than a pencil eraser (about a quarter-inch).
- E – Evolving: Look for changes in size, shape, or color, or signs like bleeding or itching.
What is the outlook for someone with a Spitz Nevus?
Most children with a Spitz Nevus do not require surgery. However, if your child undergoes a skin biopsy or surgical removal, a scar may remain. While extremely rare, a Spitz Nevus can recur after removal. Therefore, you should monitor the skin and the scar site regularly. If you notice a new lump or any unusual change, consult your doctor immediately.
When should you see a doctor?
If you notice any new moles or skin changes, especially those that fit the ABCDE criteria, contact your healthcare provider right away.
What questions should I ask my doctor?
When you visit your doctor, you might want to ask:
- How often should my child come in for a professional skin examination?
- How frequently should I perform self-checks on myself and my child?
- Is surgery necessary to remove my child's Spitz Nevus?
- What steps can I take to reduce the risk of skin cancer for my family?
What is the difference between a Spitz Nevus and Spitzoid Melanoma?
In very rare instances, a doctor might misdiagnose a lesion as a Spitz Nevus when it is actually a melanoma. Some doctors refer to these rare diagnoses as Spitzoid Melanoma or malignant Spitz Nevus. This highlights the vital importance of a biopsy.
Can a Spitz Nevus become cancerous?
A correctly diagnosed Spitz Nevus is not a skin cancer. You either have a benign (non-cancerous) Spitz Nevus or a melanoma. If a doctor has any doubt about the nature of a mole, they will certainly perform a skin biopsy to confirm the diagnosis.
It is natural to feel anxious when you notice a new spot or change on the skin, especially since a Spitz Nevus can look very similar to a melanoma. While skin cancer in children is very rare, always seek medical advice for any unusual skin changes. If your child has a Spitz Nevus, you will need to monitor it closely. Ask your doctor to teach you how to perform an effective skin examination at home.
Summary (Take-Home Message)
We hope this overview has helped you better understand the Spitz Nevus. Keep these key points in mind:
- A Spitz Nevus is usually a non-cancerous mole commonly found in children.
- Because they can mimic dangerous melanoma, always consult a dermatologist for an accurate diagnosis.
- Most Spitz Nevi do not require treatment.
- Stay vigilant regarding new moles or changes in existing ones, especially following the ABCDE rule.
- Follow sun-safety practices to protect yourself from skin cancer.
- If you have any doubts, seeking professional medical advice is always the smartest choice.
Wishing you and your family good health from Nirogi Lanka!
