Spitz nevi (also known as spindle and epithelial cell nevi or benign juvenile melanoma) are benign melanocytic nevi of early childhood. These lesions are often red, pink, or, less commonly, dark brown, and appear as well-defined, smooth, firm, flat- or dome-shaped nodules and papules often less than 6 mm in diameter.

Spitz nevi most commonly arise during childhood and adolescence; congenital Spitz nevi present at birth are rare. The majority of lesions are solitary, but rarely they can be multiple and widespread (eruptive disseminated) or localized (agminated) in one area. Widespread Spitz nevi have been reported with pregnancy, puberty, chemotherapy, and HIV.

The importance of these lesions lies in their frequent histopathologic confusion with melanoma. Spitz nevi represent the benign diagnosis within a spectrum, which extends to contain increasingly atypical features in atypical Spitz tumors (ASTs) and Spitz melanomas.

Lesions can develop slowly or appear quite rapidly. Without excision, lesions may remain stable for years, evolve into compound nevi, flatten over time, or involute spontaneously.

Related topic: agminated nevus