Пігментна пляма Шпіца (МКХ-10: D22) ⚠️

Spitz Nevus (Epithelioid and Spindle-Cell Nevus)

Spitz nevus (also called epithelioid and spindle-cell nevus) is a harmless skin growth that sticks out slightly above the skin’s surface. Usually, it develops during life rather than being present from birth, though around 10% of cases are congenital. Spitz nevi tend to appear as single spots, most commonly in children and young adults under 20. They occur equally often in men and women.

What Increases the Risk?

We don’t fully understand what causes Spitz nevi, but several factors might make them more likely to develop:

Genetics: There may be a hereditary link, meaning they can run in families.
Ultraviolet (UV) Light: Exposure to sunlight or artificial UV sources can trigger new spots, including Spitz nevi.
Hormonal Changes: Changes in hormones, especially during puberty or pregnancy, might influence their development by affecting the skin and immune system.

How Are Spitz Nevi Diagnosed?

Doctors diagnose Spitz nevus through a physical check-up, looking carefully at the spot and using a dermatoscope — a special magnifying tool that shows detailed patterns on the skin. If there’s any worry about cancer, a small sample may be taken (a biopsy) to confirm the diagnosis and rule out melanoma or other conditions.

What Do Spitz Nevi Look and Feel Like?

Spitz nevi usually appear as dome-shaped or slightly flattened bumps that stand out from the skin. They’re often symmetrical, shaped like an oval or circle. Sometimes, larger Spitz nevi can have an irregular shape. The surface might feel a bit different from the surrounding skin — either smoother or with tiny bumps — giving it a subtle raised look. The edges are usually clear and smooth, though bigger spots may have uneven borders.

The colour can vary from pale pink or flesh-toned to dark brown, with the colour evenly spread across the spot. Sometimes, the colour fades gradually from the centre outwards, or there might be slight colour variations within the spot. This kind of gradual colour change is more common in larger, wart-like Spitz nevi.

One key feature is that hair usually doesn’t grow on the spot, which helps distinguish Spitz nevi from other skin lesions.

Typically, Spitz nevi measure between 3 and 8 mm across, and they rarely stick out more than 5 to 7 mm above the skin. Larger ones are uncommon, and any noticeable growth should be checked by a specialist.

When touched, Spitz nevi feel slightly firmer than the surrounding skin. They usually don’t cause any discomfort, but sometimes long-standing spots might itch a little or feel tender.

These nevi are most often found on the face, neck, and limbs, with fewer appearing on the body. Their locations tend to be areas more exposed to sunlight.

What Does a Dermatoscope Show?

Using a dermatoscope, Spitz nevi display several typical features:

Star Pattern: This is a key sign, showing lines, dots, or small spots of pigment radiating from the centre outwards.
Symmetrical Blue-White Area: Often, a blue-white area appears in the middle, surrounded by pigmented spots.
Elasticity: Spitz nevi are flexible — when pressed, they temporarily become paler and smaller.
Blood Vessel Pattern: The spot usually shows a regular, slightly curved network of blood vessels.
Even Colouring: The whole lesion may be evenly pigmented under close examination.

What Else Could It Be?

It’s important to tell Spitz nevi apart from other pigmented skin spots, such as:

Simple mole
Papillomatous nevus (wart-like mole)
Molluscum contagiosum (a viral skin infection)
Blue nevus (a blue-coloured mole)
Dysplastic nevus (atypical mole)
Basal cell carcinoma (a type of skin cancer)
Melanoma (a serious skin cancer)

Are Spitz Nevi Dangerous?

Spitz nevi are usually harmless. However, some can look very similar to melanoma under the microscope, so they need careful assessment. Signs that a spot might be turning cancerous include sudden changes like rapid growth, colour shifts, or new pain or tenderness. If you notice any of these, it’s important to see a doctor promptly.

While it’s rare for Spitz nevi to become malignant, any suspicious or changing spots should be checked without delay. Regular monitoring is key, especially if the spot’s appearance changes.

What Should You Do?

Because Spitz nevi can be tricky to tell apart from melanoma — especially in adults or if the spot changes — it’s best to have them checked by a healthcare professional. Sometimes, removal and lab testing are needed. Annual check-ups are recommended, or more often if the spot is in a hard-to-see place and you have help to monitor it. If the spot gets injured or changes in any way, see a dermatologist or oncologist straight away.

Your doctor will decide if just watching the spot is enough or if it should be removed. If the nevus is regularly irritated by clothes, jewellery, or your job, removal might be advised to prevent damage.

If you’re keeping an eye on a Spitz nevus, taking photos can help track any changes over time. People with many moles should have skin checks in spring and autumn, before and after the sunniest months. Keeping a map of your skin spots can also be useful for monitoring.

Treatment

Treatment usually means surgically removing the Spitz nevus, either with a traditional scalpel or a radiofrequency device. The removed tissue is then examined under a microscope to confirm it’s benign.

Methods like laser removal or freezing (cryodestruction) aren’t recommended because they don’t allow for proper lab testing and might miss signs of cancer.

How to Prevent Spitz Nevi

While you can’t guarantee Spitz nevi won’t develop, you can reduce risks and protect your skin by:

Limiting UV exposure — avoid tanning beds and too much sun.
Using sunscreen and wearing protective clothing when out in strong sunlight.
Avoiding repeated skin injuries that could irritate the skin or cause spots.
Minimising exposure to ionising radiation and harmful environmental factors.
Maintaining good personal hygiene and watching for any skin changes.

Regularly checking your Spitz nevi, consulting a healthcare professional if you notice changes, and removing any potentially risky spots are important steps to keep your skin healthy and reduce complications.