An unusual presentation of spitz lesion on an adolescent's foot.

The authors present a case of spitzoid nevus of the left fourth toe in a 16-year-old boy, which was confirmed by biopsy to be a Spitz nevus. In a young individual, we feel that it is important to maintain a high index of suspicion for an atypical lesion that displays unusual physical findings. Spitz nevus is an infrequent, acquired melanocytic nevus composed of epithelial and spindle melanocytes that is difficult to differentiate from a melanoma. Presently, there are no immunohistochemical markers or molecular biologic techniques that can be used to make a completely certain diagnosis of Spitz nevus versus melanoma. Spitz tumors are most commonly located on the lower extremities in children. Treatment of the lesion is typically carried out by means of excision.