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Clinical features and outcomes of paediatric Spitz-type lesions

D Patel1, R Chawla2, A J K Patel2

  • 1School of Clinical Medicine, University of Cambridge, UK.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|August 23, 2024
PubMed

Insights

Pediatric Spitz-type lesions are typically benign and have excellent outcomes, with no recurrences or metastases reported after excision. Aggressive management is not recommended for clinically unremarkable cases in children.

Area of Science:

  • Dermatology
  • Pediatric Oncology
  • Pathology

Background:

  • Management guidelines for Spitz-type lesions in children are lacking.
  • Current UK recommendations favor a conservative approach with a low threshold for excision.
  • Clarifying clinical features and outcomes is crucial for informed management.

Purpose of the Study:

  • To describe the clinical characteristics of Spitz-type lesions in pediatric patients.
  • To evaluate the outcomes and recurrence rates of these lesions.
  • To inform management strategies for Spitz-type lesions in children.

Main Methods:

  • Retrospective cohort study of pediatric patients (≤18 years) with histologically confirmed Spitz-type lesions.
  • Data collected included demographics, lesion details, follow-up duration, and outcomes.
  • Study conducted at Addenbrooke's Hospital, UK, from November 2014 to September 2020.

Main Results:

  • Ninety-one children were included: 70.3% classic Spitz/spitzoid nevi, 28.6% atypical Spitz tumors, 1.1% spitzoid malignant melanoma.
  • Common clinical features included amelanosis (22%), raised bump (44%), bleeding (12.1%), and non-uniform color (25%).
  • No local recurrence, distant metastases, or mortality were reported after excision, with most patients discharged without follow-up.

Conclusions:

  • Pediatric Spitz-type lesions demonstrate exceptionally good outcomes and are predominantly benign.
  • Clinically banal Spitz-type lesions in children represent a low-risk condition.
  • Aggressive management strategies are not advocated for these lesions in pediatric patients.
Abstract

Keywords:
ChildExcisionMelanomaPaediatricSpitz

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