Abstract
Spitz nevus (SN) has an overall incidence ranging from 1.4 to 7 new cases per 100,000 people per year, 60% are infants and young people under 20 years of age, the desmoplastic SN variant is the most frequent subtype in late adolescence and adults. The aim of this clinical case is to recognize risk factors associated with the development of NS, to describe the clinical and dermatoscopic manifestations, and to analyze the histopathological and immunohistochemical findings of the desmoplastic NS variant. Dermoscopy, skin biopsy, histopathological and immunohistochemical studies were performed. The patient presented a dermatosis localized to the right upper limb affecting the arm, on the external face, middle third and was characterized by an exophytic nodular neoformation, surrounded by an erythematous halo of 0.8 x 0.8 cm, in the dermoscopy a multicomponent pattern accompanied by a punctate vascular pattern was observed. The biopsy showed nests of fusocellular melanocytes distributed in papillary and reticular dermis, with fibrous stroma, deep hyaline changes and accompanying small vessels. The immunohistochemical study showed positive SOX 10 and K167 expression, the diagnosis was desmoplastic Spitz nevus. The main treatment was surgical incision, with subsequent surveillance and sun care. The diagnosis of NS represents a difficulty for medical personnel since it has clinical, dermatoscopic and even histopathological similarities with atypical spitzoid lesions and melanomas, which have a higher risk of mortality, which makes it essential to recognize the wide clinical morphology of the disease.
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