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Management Guidelines for Dermoscopy of Spitz Nevi
We know that dermoscopy provides us with more information than is possible with the naked eye. The trick is to understand what the additional information means, and what we should do with it! This is where research on dermoscopy and management guidelines is so important. In this case, we are particularly looking at the management of Spitz nevi.
Lallas et al recently published an update on dermoscopy of Spitz nevi and management guidelines in the British Journal of Dermatology. The authors propose that there are three major patterns of Spitz nevi: starburst, regularly distributed and dotted vessels, and globular pattern with reticular depigmentation.
They add that any asymmetric lesions with these features should be excised to exclude melanoma. Symmetric but nodular lesions should be excised or monitored closely for the same reason. Flay lesions should be excised if >12 years of age.
There is a very nice algorithm for this decision making process, presented in this image.
Spitz nevi are not very common but they will be seen by general practitioners, and this is a useful way to consider their diagnosis and management.
Professor David Wilkinson
Read more from Professor David Wilkinson on recent research:
- Mohz Micrographic Surgery vs. Wide Local Excision for Melanoma In Situ
- Treating Melanoma in Primary Care