Spitz nevus and Reed nevus

Abstract

Spitz and Reed nevi, also called spindle and/or epithelioid cell nevi, are a special group of melanocytic lesions due to their peculiar clinical, dermoscopic and histopathological features. The study of these nevi is of great interest because both their nomenclature and classification are still a matter of discussion. Most importantly, the difficulty to differentiate them from melanoma can lead to inadequate therapies. In this context, dermoscopy, a link between clinical and anatomopathological examinations, appears as a helpful diagnostic tool whose accuracy can reach 93%. "Borderline" lesions are still a great challenge and object of research, including molecular studies. The present study explores the relevant characteristics of these nevi, with emphasis on dermoscopic findings, aiming at understanding their natural history, as well as discussing treatment and patient follow-up. Keywords: Dermoscopy; Melanoma; Nevus, epithelioid and spindle cell Resumo: Os nevos de Spitz e de Reed, ou também chamados nevos de células fusiformes e/ou epitelióides, formam um grupo especial de lesões melanocíticas, por suas características peculiares, tanto clínicas como dermatoscópicas e histopatológicas. Torna-se grande o interesse no estudo desses nevos, pois tanto a nomenclatura como a classificação ainda são motivos de debate e, sobretudo, a dificuldade de diferenciação com o melanoma pode gerar condutas terapêuticas inadequadas. Neste contexto, surge a dermatoscopia, elo entre o exame clínico e o anatomopatológico, como método diagnóstico auxiliar importante cuja acurácia pode chegar a 93%. A grande dificuldade ainda são as lesões "borderline", motivo de pesquisas, incluindo estudos moleculares. O presente estudo aborda os aspectos relevantes das características destes nevos, com ênfase nos achados dermatoscópicos, buscando o entendimento da sua história natural, além da discussão quanto ao tratamento e seguimento dos pacientes. Palavras-chave: Dermoscopia; Melanoma; Nevo de células epitelióides e fusiformes

Evolution of Spitz Nevi

“…In 1954 the term spindle cell nevus was suggested, given that Spitz nevi could also be observed in adults. Although the lesions resembled melanoma clinically and histopathologically, they were classified as benign melanocytic lesions of the skin given that they never created distant metastases . In 1975 Reed et al described a benign, deeply pigmented, melanocytic lesion on the lower extremities of young adults, known as the Reed nevus .…”

“…The clinical, dermoscopic, and histopathologic presentations of these nevi may resemble those of melanoma. These similarities lead to disagreements about strategies for the diagnosis and management of Spitz nevi . Spitz nevi also exhibit evolution (morphologic or symptomatic change).…”

A regressing spindle cell tumour of Reed

“…It is an uncommon naevus but its incidence and prevalence are not known. A Reed naevus typically goes through a rapid initial growth phrase before stabilising in size and then regresses over time 1. Awareness of Reed naevus has been demonstrated to be low, even among dermatology doctors 2…”

Application of automatic statistical post-processing method for analysis of ultrasonic and digital dermatoscopy images

“…First signs of the dermatoscopy appeared in 1948 and a Spitz nevus was introduced as ‘melanoma of childhood’ due to the potentiality of the technologies and histopathologic features at that time [5]. In 1953, Arthur C. Allen, Helwig in 1954, and other researches continued their investigations from the classification of benign and malignant nevus perspective [6]. Later, in 1987, Pehamberger et al presented a new diagnostic approach named as a ‘pattern analysis’ [7].…”