Clinical and histopathological features of pagetoid Spitz nevi of the thigh

Jina Chung, Zhimin M. Yuan, Jason B. Lee

Research output: Contribution to journalArticlepeer-review


Background: Pagetoid Spitz nevus is a rare subtype of Spitz nevus usually found on the lower extremities, particularly on the thigh of women. As a rare and under-recognized entity that can be misdiagnosed as melanoma, further characterization of clinical and histopathological features is needed to improve its recognition. Methods: A retrospective analysis of all melanocytic neoplasms from the thigh diagnosed over a 3-year period. Results: Fifty-five (15.4%) of the 357 melanocytic neoplasms on the thigh were Spitz nevi, the majority of them occurring in women (87.3%). Of the 55 Spitz nevi, 33 (60.0%) were pagetoid Spitz nevi, 14 (25.5%) were Reed nevi, and eight (14.5%) were conventional Spitz nevi. The mean age of patients with pagetoid Spitz nevi was 47.2, the majority being women (84.9%). Pagetoid Spitz nevi were small, with a mean histopathologic diameter of 4 mm, and often junctional (63.6%). Compared to Clark nevi of the thigh, pagetoid Spitz nevi comprised significantly more solitary melanocytes with a greater degree of scatter. Conclusions: These results suggest that Spitz nevi and, in particular, pagetoid Spitz nevi constitute a significant percentage of nevi on the thigh. Previously reported benign clinical and histopathological features of pagetoid Spitz nevi are confirmed in this study.

Original languageEnglish (US)
Pages (from-to)1143-1149
Number of pages7
JournalJournal of cutaneous pathology
Issue number12
StatePublished - Dec 2020
Externally publishedYes


  • atypical spitz tumor
  • melanoma
  • misdiagnosis
  • pagetoid Spitz nevus
  • thigh nevus

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Dermatology


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