Spitz nevus is uncommon, benign melanocytic neoplasm that may show some clinical, dermoscopical and histological features of melanoma. It occurs often in childhood, but may appear also in early adulthood. Rare congenital cases have been reported in literature. It is frequently located on the face and the lower extremities, but in some cases may appears on the trunk. Methods: We report a case of a 9-years-old girl presented to our Dermatology Unit because of the presence of a pigmented lesion on her right leg, 4 mm in diameter, which was clinically and dermoscopically diagnosed as Spitz nevus. We described the clinical and dermoscopic features that we observed every six months, over 11 years follow-up period. Objective: Our observation show that the globular, the starburst, the homogeneous patterns and diffuse brown colour with diffuse hypopigmented areas may be the different expression that correspond to possible evolutionary phases of pigmented Spitz nevus
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