Spitz Nevus

What is a Spitz nevus?

A Spitz nevus is a type of noncancerous (benign) mole that typically appears during childhood. It usually looks like a round pink bump. They can sometimes look flat or rough, or have a different color like blue, black or brown. A healthcare provider may also refer to a Spitz nevus as an epithelioid or spindle-cell nevus.

It can be alarming to find a Spitz nevus on your child. They can look like melanoma, a life-threatening skin cancer. Fortunately, Spitz nevi (the plural form of nevus) aren’t skin cancer.

Even though a Spitz nevus is rarely cause for concern, it’s still important to see a healthcare provider to get an accurate diagnosis. Most children with a Spitz nevus don’t need any treatment. Your provider might remove a Spitz nevus on your child if it starts changing shape or size.

What does the term Spitz nevus mean?

A Spitz nevus is the medical name for a specific type of mole:

• Spitz refers to American pathologist Dr. Sophie Spitz who studied these moles on children in the late 1940s.
• Nevus is the medical term for a mole, which is a type of birthmark. Moles form when cells in your skin called melanocytes clump together, causing a change in skin color.

How common are Spitz nevi?

Most people have a few common moles (also known as acquired moles). These harmless moles can appear anytime throughout your life. Some people with lighter skin can have as many as 40 common moles.

Spitz nevi are rare. These moles account for about 1% of all surgically removed (biopsied) moles.

What causes a Spitz nevus?

Experts aren’t sure what causes Spitz nevi. Some people might have a gene change (genetic mutation) that makes them more likely to have these moles.

Who is at risk for Spitz nevi?

Moles affect people of all ages, sexes and skin colors. People with lighter skin are more likely to have Spitz nevi. Most Spitz nevi are acquired (common) moles, which means they appear after childbirth.

Spitz nevi can appear at any point in your life. Each age group develops about one-third of cases:

• Before 10 years old.
• Between 10 and 20 years old.
• After the age of 20.

It’s rare, but a Spitz nevus can be present at birth (a congenital birthmark).

What does a Spitz nevus look like?

A Spitz nevus usually looks like a pink or red raised bump. They can also be flat or blue, brown, tan or black.

Most people only have one Spitz nevus, although they can develop in clusters.

Spitz nevi usually:

• Resemble a wart.
• Grow for a few months to around half an inch (one centimeter) in diameter.
• Ooze, bleed or itch.
• Shrink and flatten out after a few years. They sometimes disappear completely.

What does melanoma in a child look like?

It’s extremely rare for a child to have melanoma. There are fewer than 400 cases of childhood melanoma in the U.S. each year. When a child has melanoma, the growth often looks like a Spitz nevus.

The signs of a melanoma growth include:

• A raised shape, like a bump or wart.
• The growth appears, gets bigger and changes quickly.
• A single color, usually red, pink, purple or the same color as your skin.
• Itching.
• Bleeding that heals then comes back (recurs).

Where do Spitz nevi appear?

A Spitz nevus can appear anywhere on your body. The most common places they develop include your:

• Face.
• Neck.
• Trunk (abdomen).
• Arms.
• Legs.

How are Spitz nevi treated?

Visit a dermatologist if you notice any growths or changes on your skin. This is especially important because a Spitz nevus and a melanoma growth look so much alike.

A dermatologist will look at the growth and ask you when you noticed it or if it’s changed recently. They might also perform a few tests, including:

• Dermoscopy: A skin examination using a dermatoscope (a special magnifying glass) to look for irregularities in your mole.
• Mole mapping: Using a special camera with a dermatoscopic lens to see changes to the shape, size and color of moles.
• Skin biopsy: A skin biopsy is the only way to know for sure whether a mole is cancerous. Your dermatologist will remove a sample of skin tissue from your mole and examine it for signs of cancer.

How are Spitz nevi treated?

Most people with Spitz nevi don’t need treatment. However, your provider may suggest annual skin examinations and mole mapping to monitor the mole for unusual changes.

Your dermatologist might surgically remove a Spitz nevus and some surrounding skin and tissue if the mole is:

• Asymmetrical or irregular in shape or pattern.
• Bleeding, oozing or itchy.
• Larger than half an inch (1 centimeter) in diameter.

Can I prevent a Spitz nevus?

People get moles for no known reason. There isn’t anything you can do to prevent yourself or your child from developing a Spitz nevus.

How can I prevent skin cancer?

Everyone’s at risk for skin cancer. You can take these steps to protect your skin from sun damage:

• Apply a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30 every day even when indoors.
• Don’t use tanning beds or sunlamps.
• Try to do outdoor activities before 10 a.m. or after 4 p.m. when the sun’s rays are less strong. Seek shade if you must be outside during those hours.
• Wear sun-protective clothes, including a wide-brimmed hat and large sunglasses when outdoors.

How can I detect unusual skin changes?

You should perform skin self-exams on yourself and your children to check for changes in your skin and moles. Healthcare providers recommend performing skin examinations at least once a month if you have a family history of skin cancer. You can also take photos of moles to help identify changes.

The ABCDE rule for skin cancer can help you detect moles that require a provider’s attention. Look for these signs:

• Asymmetrical or irregular in shape.
• Borders that are blurry, notched or ragged.
• Colors that include a combination of browns, blacks, reds and blues. (Remember, melanoma on a child is often one color and is usually red, pink, purple or flesh-colored.)
• Diameter that’s larger than a pencil eraser (one-quarter of an inch).
• Evolving changes, such as moles that grow, change shape or color, bleed or itch.

What is the outlook for someone with a Spitz nevus?

Most children with Spitz nevi don’t need surgery. But if your child has a skin biopsy or surgery to remove their mole, they may have a scar. It’s rare, but Spitz nevi sometimes regrow after they’re removed. You should check your child’s skin and scar. Visit a provider if you notice a bump or other skin changes.

When should I call the doctor?

Call your healthcare provider if you notice new moles or skin changes, including the ABCDE signs of skin cancer.

What should I ask my provider?

• How often should my child need an in-office skin exam?
• How often should I do an at-home skin exam on my child and myself?
• Will my child need surgery to remove a Spitz nevus?
• What steps can I take to lower my family’s risk of skin cancer?

What’s the difference between a Spitz nevus and Spitzoid melanoma?

In very rare instances, a healthcare provider may incorrectly diagnose a mole as a Spitz nevus when it’s actually melanoma. Some providers refer to the new cancer diagnosis as Spitzoid melanoma or a malignant (cancerous) Spitz nevus.

Can a Spitz nevus become cancerous?

An accurately diagnosed Spitz nevus mole won’t develop into skin cancer. You have either a benign Spitz nevus mole or melanoma. If your provider is uncertain about the cancer status of a mole, they may do a skin biopsy to be sure.

A note from Cleveland Clinic

Any type of skin change or new growth can be concerning, especially when a mole like a Spitz nevus looks so much like melanoma. Even though it’s extremely rare for a child to have skin cancer, it’s still important to get any unusual skin changes checked. If your child has a Spitz nevus, they may need more frequent skin examinations to monitor it for changes. Ask your healthcare provider to show you how to do skin self-exams on yourself and your children.