19 yo F skin, right lateral ankle, shave bx. 6mm lesion under the scope. Diagnosed by Dr. Cockerell. (来自@孔祥田(Max)*Roswell*NM] )

and in my opinion, the changes are those of probable epithelioid cell nevus (Spitz).

There is a proliferation of nevus cells at the dermoepidermal junction and in the dermis which are large and polygonal in shape with prominent nuclei demonstrating features of an epithelioid cell variant of a Spitz's nevus.

I favor the diagnosis of an unusual Spitz's nevus in this case. The lesion does have some unusual features, namely some areas in which there are a greater number of single cells in the epidermis as well as some coalescence of cells in the papillary dermis and scattered mitotic figures. Given the relative young age of the patient as well as the maturation and overall symmetry, I favor the diagnosis of a nevus, but I would recommend that this lesion be completely excised and the reexcision specimen be reevaluated in the context of these sections before a final diagnosis was rendered.

Thanks so much for allowing me the opportunity to review these sections. Best wishes to you.

Sincerely yours,

Clay J. Cockerell, MD

 考虑复合痣，增生比较活跃。