Pedrazini Maria Cristina, Montalli Victor Angelo Martins, Souza Elemir Macedo de
Faculdade São Leopoldo Mandic, Campinas, SP, Brasil.
Universidade Estadual de Campinas, Campinas, SP, Brasil.
Rev Paul Pediatr. 2017 Oct-Dec;35(4):476-479. doi: 10.1590/1984-0462/;2017;35;4;00016. Epub 2017 Sep 21.
To report the clinical evolution and handling of a Spitz nevus, from its initial flat feature to becoming an irregular, nodular, reddish lesion.
Female child, phototype II, with a small congenital nevus on the left lower limb and other sustained small nevi. The patient went through annual clinical and dermoscopic evaluations between the ages of three and seven, period during which the nevi located on the left thigh grew rapidly. The clinical hypothesis was Spitz nevus, with indication of surgical removal with a safety margin and anatomopathological study. Considering patient's age and clinical/histological aspects, the diagnosis of Spitz nevus was confirmed.
Initial globular pattern and size under 5 mm upon dermoscopy allowed clinical follow-up. However, onset of hyperchromia and rapid growing of the lesion, along with aesthetic concerns, possibility of trauma in the region, and risk of malignancy at puberty guided the decision of total resection and follow-up for recurrence.
报告1例斯皮茨痣的临床演变及处理过程，该痣最初表现为扁平状，后来发展为不规则、结节状、红色病变。
一名II型光皮肤型女童，左下肢有一个小的先天性痣以及其他一些持续存在的小痣。该患者在3至7岁期间每年进行临床和皮肤镜评估，在此期间，位于左大腿的痣迅速生长。临床诊断考虑为斯皮茨痣，建议进行带安全切缘的手术切除并做解剖病理学研究。综合患者年龄及临床/组织学表现，斯皮茨痣诊断得以确诊。
皮肤镜检查最初呈球状形态且大小小于5mm，故可行临床随访。然而，病变出现色素沉着加深和快速生长，同时考虑到美观问题、该区域可能受到创伤以及青春期恶变风险，最终决定进行完整切除并随访有无复发。
