Francesco Ricci1, Andrea Paradisi2, Giorgio Annessi3, Mauro Paradisi4, Damiano Abeni5. 1. Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy, Clinical Epidemiology Unit, IDI-IRCCS - FLMM, Rome, Italy. 2. Clinical Epidemiology Unit, IDI-IRCCS - FLMM, Rome, Italy, Dermatology Unit, "Cristo Re" General Hospital, Rome, Italy. 3. Laboratory of Dermatopathology, IDI-IRCCS - FLMM, Rome, Italy. 4. Campus Bio-Medico University of Rome, Rome, Italy. 5. Clinical Epidemiology Unit, IDI-IRCCS - FLMM, Rome, Italy.
Abstract
BACKGROUND: The solitary form of Spitz nevus is a common clinical entity in children, typically occurring on the face and extremities. However, less frequent variants of Spitz nevi, such as agminated forms and eruptive disseminated Spitz nevi (EDSN), have been described. The agminated form is characterised by localised clusters or segmental distribution of Spitz nevi on the face, back, or extremities. First described as "eruptive juvenile melanomata", EDSN is the rarest clinical variant, consisting of a widespread eruption of Spitz nevi, most frequently involving the trunk, buttocks, and proximal limbs, and usually occurs in the second to third decade of life. OBJECTIVES: To describe a case of EDSN and review the literature. MATERIALS & METHODS: Twenty-seven cases of EDSN, including a 12-year-old female patient with EDSN presented here, were reviewed. RESULTS: EDSN generally exhibits an abrupt, eruptive onset (developing over few months), followed by a slow progressive course of new lesions that continue to appear over a long period, resulting in hundreds of papules and nodules. In all reported cases, the EDSN lesions involved the trunk, often affecting the legs and arms, and sometimes the scalp. A number of possible precipitating factors were reported. CONCLUSION: A periodic self-examination, total body photography, a dermoscopic 3-6-month follow-up during the eruptive phase (extending to 9-12 months during the stable phase), and prompt surgical excision of lesions that may be malignant is recommended, however, to date, no malignant transformation of EDSN has been reported.
BACKGROUND: The solitary form of Spitz nevus is a common clinical entity in children, typically occurring on the face and extremities. However, less frequent variants of Spitz nevi, such as agminated forms and eruptive disseminated Spitz nevi (EDSN), have been described. The agminated form is characterised by localised clusters or segmental distribution of Spitz nevi on the face, back, or extremities. First described as "eruptive juvenile melanomata", EDSN is the rarest clinical variant, consisting of a widespread eruption of Spitz nevi, most frequently involving the trunk, buttocks, and proximal limbs, and usually occurs in the second to third decade of life. OBJECTIVES: To describe a case of EDSN and review the literature. MATERIALS & METHODS: Twenty-seven cases of EDSN, including a 12-year-old female patient with EDSN presented here, were reviewed. RESULTS: EDSN generally exhibits an abrupt, eruptive onset (developing over few months), followed by a slow progressive course of new lesions that continue to appear over a long period, resulting in hundreds of papules and nodules. In all reported cases, the EDSN lesions involved the trunk, often affecting the legs and arms, and sometimes the scalp. A number of possible precipitating factors were reported. CONCLUSION: A periodic self-examination, total body photography, a dermoscopic 3-6-month follow-up during the eruptive phase (extending to 9-12 months during the stable phase), and prompt surgical excision of lesions that may be malignant is recommended, however, to date, no malignant transformation of EDSN has been reported.