A 14-year-old girl with no past history of interest was seen for an asymptomatic lesion that had arisen on the helix of the auricle of her left ear 2 months earlier. The lesion had appeared during the month of August and had not changed since that time.

Examination revealed an 8mm nodular lesion with well-defined, slightly elevated borders and a central erosion (Fig. 1A).

Figure 1

(0.32MB).

Epidermal hyperplasia, hyperkeratosis, acanthosis, and hypergranulosis were observed on biopsy, associated with nests of nonpigmented epithelioid cells in the epidermis, extending down to the reticular dermis. Fibrillary eosinophilic globules consistent with Kamino bodies were identified in the papillary dermis (Fig. 1B).

With a diagnosis of Spitz nevus, the lesion was excised and has not recurred after 2 years of follow-up.

Spitz nevus is an acquired benign melanocytic tumor that typically arises before 20 years of age. It presents as an asymptomatic, firm, well-defined solitary papule of variable color. The nevus typically arises on the head and neck, lower limbs, or trunk. The differential diagnosis includes other melanocytic nevi, hemangioma, pyogenic granuloma, molluscum contagiosum, and keloids. The age of our patient and the appearance of the lesion during the summer also led to a suspicion of cutaneous leishmaniasis. Chondrodermatitis nodularis helicis was excluded by the age of the patient.