Can you identify this black mole?

A concerned mother brings her 7-year-old son to your office for examination of a black mole on his shoulder. She is convinced that the lesion, which appeared 6 months ago, is growing larger.

Which of the following do you suspect?

A. Combined nevus.

B. Junctional nevus.

C. Dysplastic nevus.

D. Melanoma.

E. Spitz nevus.

(Answer on next page.)

Answer: Spitz nevus

The clinical suspicion of Spitz nevus, E, was confirmed by a punch biopsy. Spitz nevi, which occur commonly in the pediatric population, erupt as red or darkly pigmented papules. All the diagnoses in the differential are reasonable in this setting; melanoma does occur in children, albeit rarely. No treatment is needed.