There are two main types of spitz naevi:

1) Classical spitz naevus is a rapidly growing pink papule/nodule on the face or limbs of a child or young adult.

2) Pigmented spitz (including spindle cell naevus of Reed) is again a rapidly growing brown or black papule or macule on the limbs of  young adults. 

 

**Some melanomas can mimic spitz naevi and so most are managed with surgical excision**.

 

There are many dermoscopic patterns associated with spitz naevi:

 

Pink homogenous.

Dermoscopy reveals pink homogenous pigmentation with usually dotted vessels. They will often have white intersecting lines.

 

 

 

 

 

 

 

 

 

 

 

Starburst pattern.

The classical starburst pattern of a spitz naevus is formed from symmetrical radial projections around the entire lesion. The projections are usually connected to the main body of the lesion and are also know as pseudopods or, if forming radial lines, radial streaming.

 

 

 

 

 

 

 

 

 

 

 

Globular pattern.

Spitz naevi can present with a globular pattern. The globules can be diffuse or in 'tiers' around the periphery of the lesion.

 

Atypical patterns.

Sometimes spitz naevi can present with an atypical pattern with irregular homogenous pigment and a blue white veil. This often mimic melanomas.

 

 

 

 

 

 

 

 

 

 

Dark homogenous pattern.

This pattern presents with a dark homogenous pattern without obvious peripheral streaks.