A Spitz nevus can arise de novo or in association with an existing melanocytic nevus. Spitz nevi have been described almost exclusively in fair-skinned individuals. Some authors describe a slight female predominance. After its appearance, the lesion tends to grow rapidly, and may reach a size of 1 cm within 6 months. Single, dome-shaped, red or pigmented papules or nodules are typical.
Most lesions occur on the face or legs.
The color may vary from nonpigmented through pink to orange-red. Some lesions are pigmented, especially those found on lower extremities. Note that the rare recurrences may mimic metastatic malignant melanoma. Histopathological evaluation of a suspected Spitz nevus is indicated. The classic Spitz nevus is predominantly compound, though junctional and intradermal lesions also are observed.