Pediatric Atypical Spitzoid Neoplasms: A Review with Emphasis on ‘Red’ (‘Spitz’) Tumors and ‘Blue’ (‘Blitz’) Tumors

BACKGROUND: The diagnosis of pediatric atypical Spitz nevus/tumors (pASNT) is an emerging challenge in clinical dermatology and dermatopathology. OBJECTIVE AND METHODS: We review the main clinicopathologic issues raised by pASNT and describe 2 examples of different clinicopathologic subsets of lesions. RESULTS: While Spitz/Reed nevi are commonly small- to medium-sized, tan to black plaques, pASNT are large and nodular, either 'red' (dotted and/or polymorphous vascular pattern on dermoscopy; spindle and/or epithelioid tumors on histopathology: Spitz tumors, sensu strictiori) or 'blue' (homogeneous blue color on dermoscopy; intimate admixture of epithelioid cells and heavily pigmented dendritic cells on histopathology: Blitz tumors or pigmented epithelioid melanocytomas). CONCLUSIONS: Different clinicopathologic settings of pASNT probably exist. Dermoscopy can aid in their recognition and classification.