Spitz / Reed nevi
Spitz ⁄Reed nevi are acquired melanocytic nevi, that are seen in both children and adults, rarely in elderly patients.
Clinically, pigmented Spitz/Reed nevi are brown to black, flat to slightly elevated, symmetrical lesions showing a relative preference for certain locations, including face, limbs and buttocks. The most relevant and peculiar feature is the starburst pattern seen by dermoscopy. This is typified by multiple streaks of pigmentation or large globules arranged symmetrically at the periphery of the lesion in a radiating pattern like that of a star. Dotted vessels and reticular depigmentation are seen in nonpigmented lesions.
Histopathologically, starburst nevi are junctional or compound neoplasms composed of heavily pigmented, highly cohesive spindle and ⁄or epithelioid melanocytes, parallel and ⁄or perpendicular to the skin surface with variable epidermal hyperplasia. ).
It should be noted that melanoma might rarely exhibit a type of starburst pattern, especially in lesions undergoing change in adults. In these circumstances, excision of lesions with a starburst pattern is recommended.
Classical Spitz nevi are plaque- or dome-shaped lesions that are typically symmetrical and sharply demarcated. They are made up of large spindle and ⁄or epithelioid cells that are mainly arranged in nests. Pigmentation is usually sparse or may even be absent. The dermal component often has a desmoplasia encircling single melanocytes (‘desmoplastic Spitz nevus’).