Spitz Nevus!

Hi Doctor , excuse me for my English, but i am Italian!!!

Please Doctor help me because I am very worried. I am 25 years old man and about 10 months ago I had on the right ear a dome shaped nodule removed with laser.  It was very dark brown/black mole  that I had never seen before, it came out in 2-3 weeks… it was 4 mm.
Histological examination says that it was a Spitz nevus;  The pathologist who has seen the mole told me that there was no mitosis and no ulceration but that the lesion was on the limit; the pathologist said that there was an irregular distribution of pigment and marked cellular pleomorphism.
For  added security  the pathologist sent the biopsy to another dermatopathologist,  Professor Guido Massi  of the University of Rome.  I think he's a good dermatopathologist, he also studied at the University of New York.

He says:
dear colleague I am completely agree with his diagnosis of Spitz nevus. However it should be noted that the lesion is of exceptional difficulty of interpretation and a close follow up is necessary together with an enlargement of the incision.

I have made further enlargement and further histology says that there was only a small scar left by the first surgery with nothing under.

Doctor I don’t know if I can consider myself cured; My dermatologist does not want me to do follow-up, He says it is unnecessary…
This type of nevus can give metastases in the future? What do you advise me to do?
Thanks Doctor.

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum!

If histopathology confirmed diagnosis, as well as that the excision of Spitz nevus was done with clear margins, treatment is over. The prognosis is very good.

Still, I would recommend regular follow ups (every six months). Recurrences (theoretically possible) can be treated with re-excision.

Wishing You Optimal Health,
Dr. Jasmina Jankicevic

[thestand]

Thank you for your response Doctor. What should I do for follow-ups? How long do i have follow-ups?

[Jasmina Jankicevic, MD, MSc, CCRP]

There is no particular preparation on your behalf. Dermatologist will clinically evaluate localization of excised nevus. The rest of skin should be inspected as well and detailed personal and family history on moles taken. Based on all that dermatologist will recommend the frequency of regular mole checks (usually once in 6 months to once a year).  

Wishing You Optimal Health,
Dr. Jasmina Jankicevic