Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(4):e2022158 1

Dermoscopic Findings of the Evolving Pigmented 
Spitz Nevus in a Child

Joanna Pogorzelska-Dyrbuś1, Beata Bergler-Czop2

1 “Estevita” Specialist Medical Practice, Tychy, Poland

2 School of Medicine in Katowice, Medical University of Silesia in Katowice, Department of Dermatology, Katowice, Poland

Citation: Pogorzelska-Dyrbuś J, Bergler-Czop B. Dermoscopic findings of the evolving pigmented Spitz nevus in a child.  
Dermatol Pract Concept. 2022;12(4):e2022158. DOI: https://doi.org/10.5826/dpc.1204a158

Accepted: January 27, 2022; Published: October 2022

Copyright: ©2022 Pogorzelska-Dyrbuś et al. This is an open-access article distributed under the terms of the Creative Commons 
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted 
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication.

Corresponding author: Joanna Pogorzelska-Dyrbuś MD, PhD Specjalistyczna Praktyka Lekarska “Estevita”, Pasaz Europejski 8/1 Street, 
43-100 Tychy, Silesia, Poland, Telephone: +48604542643 E-mail: jpogorzelskadyrbus@gmail.com

Case presentation

A 12-year-old girl presented for a routine  examination 

with a 4-mm oval-shaped dark brown papule on the 

right temple which slowly grew since her early childhood 

( Figure  1A).  Dermoscopy showed a homogenous half-blue 

and half-brown presentation (Figure 1B 20x, FotoFinder 

GmBH). The lesion has changed subtly within two years 

(Figure 1C). After three years, the lesion displayed a uniform 

blue-brown color with streaks distributed at the periphery 

(Figure 1D). The high magnification dermoscopy revealed 

peripherally distributed brown roundish cells [1] (Figure 1E, 

F, 400x, FotoFinder GmBH). The patient underwent excision 

of the lesion and histopathological diagnosis of Spitz nevus 

was established. The consent to publish data has been ob-

tained from the patient’s parents.

Teaching point

Typical for children Spitz nevi usually occur as a solitary, 

rapidly growing, pink nodule on the face [2]. This case 

 represents a less common presentation of Spitz nevus in 

childhood, with changes extremely extended in time.

References

1. Cinotti E, Tognetti L, Campoli M, et al. Super-high magnification 

dermoscopy can aid the differential diagnosis between melanoma 

and atypical naevi. Clin Exp Dermatol. 2021;46(7):1216-1222. 

DOI: 10.1111/ced.14566. PMID: 33486758.

2. Lallas A, Apalla Z, Ioannides D, et al. Update on dermoscopy of 

Spitz/Reed naevi and management guidelines by the International 

Dermoscopy Society. Br J Dermatol. 2017;177(3):645-655. DOI: 

10.1111/bjd.15339. PMID: 28118479.



2 Image Letter | Dermatol Pract Concept. 2022;12(4):e2022158

Figure 1. (A) The clinical presentation of the nevus - a 4-mm oval-shaped dark brown papule. (B) Dermoscopic image of the nevus at the first 

visit with a homogenous half-blue and half-brown presentation. (C) Subtle changes in dermoscopic features of the nevus after two years, with 

streaks appearing in the upper left quadrant (claret asterisks). (D) Dermoscopic image of the nevus after three years with uniform blue-brown 

color with streaks distributed at the periphery (green asterisks). (E and F) High magnification dermoscopic image of the lesion revealed 

blue-grey background with distinctive brown oval structures corresponding to the hair follicles (blue arrows) and peripherally distributed 

brown roundish cells corresponding to peripheral streaks (red arrows).