Spitz nevus, a distinct type of melanocytic nevus, often presents as a solitary, flesh-colored or pink dome-shaped papule, sometimes with minimal pigmentation. Clinically, it mainly affects children and adolescents and usually appears on the head, neck, and limbs. In terms of epidemiology, Spitz nevi are relatively uncommon, accounting for only a small proportion of all melanocytic nevi. However, they are of great clinical significance due to their morphological similarities with malignant melanoma. Their incidence shows no significant differences between genders, but is more common in children and young people.
How does Dermatoscopy Work?
Dermatoscopy, also known as epiluminescence microscopy, is a non-invasive diagnostic technique that uses a dermatoscope to magnify and illuminate the skin surface, allowing for a clearer observation of skin lesions. The dermatoscope typically consists of a light source and a magnifying lens, which can enhance the visibility of subtle structures and colors of the lesion.
Currently, dermatoscopy is widely used by dermatologists for diagnosing Spitz nevi. Based on dermatoscopic features, Spitz nevi can be classified into several patterns, such as starburst, globular, multicomponent/atypical, homogeneous, reticular, and dotted vessels.
Which IBOOLO Dermatoscope Model is Recommended ?
The most versatile of the IBOOLO dermatoscope models is the DE-4100 PRO. The DE-4100 PRO features virtually all of the common light modes-white polarized light, white amber light, white unpolarized light, and UV light. These four light modes can be used to visualize almost all types of lesions. In non-polarized mode, the surface texture of a spitz nevus is clearly visible at 10X magnification, and localized details that may be missed by the naked eye are also very visible. In polarized mode, stray light is filtered out and the user can observe the dermal layer of the spitz nevus. Polarized amber light can be used to observe pigmentation and spitz nevi in people with darker skin tones. And UV light may not be as useful for spitz nevus visualization, but fungal lesions fluoresce very well in this mode.
How to Properly Use a Dermatoscope on a Spitz Nevus?
Before using the IBOOLO Dermatoscope to visualize a patient's Spitz nevus, the user must first clean the area under observation. Ensure that there are no other interfering substances attached to the skin, such as cosmetics, etc. The DE-4100 PRO has a three-speed brightness adjustment function, allowing the user to adjust the light according to the brightness of the surrounding environment. Next, if you want to use the dermatoscope with bare eyes, you can use the included EYE PIECE for clearer observation. If you want to save the image, you can connect the dermatoscope to your phone using the accessory included in the kit.
What is the Dermatoscopic Image of Spitz Nevus?
The starburst pattern is characterized by a central blue-black pigmented area surrounded by streaks or large globules extending symmetrically and radially at the periphery. The globular pattern consists of numerous brown or gray-black round/oval structures of varying sizes covering most of the lesion. A reticular pattern refers to a pigment network occupying the majority of the lesion, while a homogeneous pattern shows uniform pigmentation covering most of the lesion. A multicomponent pattern is observed when two or more of the above-mentioned patterns are present in a single lesion.
Can Dermatoscopy Distinguish Spitz Nevus from Malignant Melanoma?
Distinguishing Spitz nevi from malignant melanoma is a major challenge in clinical practice. Dermatoscopy provides valuable information for differentiation. Malignant melanoma often exhibits asymmetry, irregular borders, multiple colors, and specific structures like atypical pigment networks and blue-black areas. In contrast, Spitz nevi typically show symmetry, regular borders, and relatively uniform colors. However, some atypical Spitz nevi may share certain features with malignant melanoma, leading to diagnostic difficulties. In such cases, additional diagnostic methods like histopathological examination may be required.
As for whether Spitz nevi should be excised, it depends on various factors, including the size, location, growth rate of the lesion, and the patient's symptoms. Generally, for typical Spitz nevi with no signs of malignancy, regular follow-up observation is recommended. However, if the lesion exhibits rapid growth, changes in shape or color, or other suspicious signs, surgical excision may be considered to rule out malignancy.
Are There Other Skin Lesions Similar to Spitz Nevus?
In addition to malignant melanoma, Spitz nevi also need to be differentiated from other skin lesions, such as congenital melanocytic nevi, blue nevi, and Reed nevi. Congenital melanocytic nevi are present at birth or develop shortly after birth, vary in size, and have distinct clinical and histological features. Blue nevi are characterized by blue or blue-black skin lesions, primarily caused by the aggregation of melanocytes deep in the dermis. Reed nevi, also known as congenital melanocytic spindle cell nevi, present as dark brown or black macules or papules and have unique histological features. Dermatoscopy can identify specific features of these different skin lesions, providing important evidence for differential diagnosis.