Spitz naevus (spindle and epithelioid cell naevus)

Synonyms
Spitz-Nävus, Spitz-Naevus, Spindelzellnävus, Epitheloidzellnävus, Reed-Nävus, pigmentierter Spindelzelltumor Reed, Spitz nevus, Reed naevus
Specialty
Dermatology · Skin tumours
Images
Clinical 1 · Dermoscopy 1 · Histology 4
In the app
1 flashcards
Last updated
10/2026 · Dr. Pascal Bafteh
Contents
  1. Images (6)
  2. Definition
  3. Occurrence & epidemiology
  4. Aetiopathogenesis
  5. Clinical features
  6. Histology
  7. Diagnosis
  8. Differential diagnoses
  9. Keep learning in the app
  10. References (selection)
  11. Cross-references

Images (6)

Spitz naevus (spindle and epithelioid cell naevus) – clinical photo: small, symmetrical, uniformly pink-tan papule
small, symmetrical, uniformly pink-tan papuleThe Armed Forces Institute of Pathology (AFIP), Public domain, via Wikimedia Commons · Public domain · Source
Spitz naevus (spindle and epithelioid cell naevus) – dermoscopy: starburst pattern with a black centre and a closed rim of streaksDermoscopy
dermoscopy: starburst pattern with a black centre and a closed rim of streaks. (Photo: Pascal Bafteh)Photo: KLINIKFUCHS · published with patient consent
Spitz naevus (spindle and epithelioid cell naevus) – histology (H&E), overview: a symmetric, superficially confined junctional melanocytic proliferation with heavily pigmented nests at the tips of elongated rete ridges, a band-like …Histology
histology (H&E), overview: a symmetric, superficially confined junctional melanocytic proliferation with heavily pigmented nests at the tips of elongated rete ridges, a band-like …Nephron, „Spitz nevus - intermed mag", CC BY-SA 3.0, via Wikimedia Commons · CC BY-SA 3.0 · Source
Spitz naevus (spindle and epithelioid cell naevus) – histologyHistology
Spitz naevus (spindle and epithelioid cell naevus) – histologyLWozniak&KWZielinski, „SkinTumors-446", CC BY-SA 3.0, via Wikimedia Commons · CC BY-SA 3.0 · Source
Spitz naevus (spindle and epithelioid cell naevus) – histology (H&E), heavily overstained field: abundant melanin in the upper dermis (melanophages) and pigmented cells reaching the upper epidermal layers; individual junctional nests …Histology
histology (H&E), heavily overstained field: abundant melanin in the upper dermis (melanophages) and pigmented cells reaching the upper epidermal layers; individual junctional nests …LWozniak&KWZielinski, „Skin Tumors-263", CC BY-SA 3.0, via Wikimedia Commons · CC BY-SA 3.0 · Source
Spitz naevus (spindle and epithelioid cell naevus) – histology (H&E): nests of large spindled and epithelioid melanocytesHistology
histology (H&E): nests of large spindled and epithelioid melanocytesLWozniak&KWZielinski, „SkinTumors-214", CC BY-SA 3.0, via Wikimedia Commons · CC BY-SA 3.0 · Source
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Definition

A Spitz naevus is an uncommon, benign melanocytic naevus composed of epithelioid and/or spindle-shaped melanocytes. Clinically and histologically it may resemble melanoma. It belongs to the spectrum of Spitz tumours, which comprises Spitz naevus, Spitz melanocytoma (intermediate) and rare Spitz melanoma.

Occurrence & epidemiology

Spitz naevi occur mainly in children; 70% are diagnosed in the first 20 years of life. They also arise in adults and are most frequent in fair skin.

Aetiopathogenesis

A distinct molecular pathway is characteristic, mainly kinase fusions or HRAS aberrations; it separates bona fide Spitz neoplasms from Spitz-like naevi and melanomas with conventional driver mutations.

Clinical features

  • Classic: dome-shaped red to reddish-brown papule.
  • Pigmented: tan to brown papule or nodule.
  • Pigmented spindle cell tumour of Reed: bluish-black papule.
  • Size from a few millimetres to 1–2 cm, mainly on the face and limbs, usually solitary.
  • Rapid growth over a few months is typical, often followed by years without change; spontaneous regression is possible.

Histology

Usually a symmetrical compound naevus made of nests of characteristic epithelioid cells (classic and pigmented types) or spindle cells (Reed); both cell types can coexist. Distinguishing atypical Spitz tumours from melanoma is often difficult histologically.

Diagnosis

  • Dermoscopy: classic type with evenly distributed dotted or rounded vessels; pigmented type with a starburst or globular pattern, later homogeneous; Reed type with a deeply pigmented starburst pattern with pseudopods. No pattern reliably excludes melanoma.
  • Histological confirmation, particularly in older children and adults; molecular studies help in unclear cases.

Differential diagnoses

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References (selection)

  1. DermNet: Spitz naevus
  2. PubMed: Spitz melanocytic tumours - a review (PMID 34958498)
  3. PubMed: Spitz nevus, Spitz tumor, and spitzoid melanoma: a comprehensive clinicopathologic overview (PMID 24075547)

Cross-references

Mentioned in

More skin tumours

Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases.