HX16 Spitz naevus and the woman behind it: the story of Dr Sophie Spitz

Abstract Dr Sophie Spitz (1910–1956), an American pathologist, was a pioneering figure whose work in dermatopathology remains integral to modern dermatology. Her groundbreaking work on melanocytic lesions, particularly the eponymous Spitz naevus, redefined diagnostic approaches to benign juvenile melanomas and left an indelible mark on dermatological practice. Despite her monumental contributions, Spitz’s achievements were accomplished against the backdrop of significant societal and professional challenges, including the pervasive gender biases of her time. Born in Nashville, Tennessee, Spitz displayed an early aptitude for science, graduating with honours from Vanderbilt University and later earning her medical degree. She developed a keen interest in pathology, ultimately working at the Memorial Sloan Kettering Cancer Center in New York, where her career flourished. At a time when only 6% of physicians in the USA were women, Spitz carved out her place through rigorous research, meticulous observation and an unparalleled ability to interpret histological subtleties. Spitz’s seminal 1948 paper, ‘Melanomas of Childhood’, published in the American Journal of Pathology, presented a detailed study of melanocytic lesions in children, demonstrating that these lesions, previously feared to be malignant, often had a benign course. Her findings challenged prevailing dogmas. The concept of Spitz naevus emerged from this work, and it remains a cornerstone of dermatopathological diagnosis today. Spitz naevi, benign proliferations of epithelioid and/or spindled melanocytes, usually appear during childhood. They are most commonly found on the central face, but can also be found at the lower extremities. Clinically, Spitz naevi are well-circumscribed, dome-shaped, pink, smooth lesions and are typically < 6 mm in diameter. Histologically, Spitz naevi consist of large junctional and dermal melanocytic nests formed by spindled or epithelioid cells. In 1953, Allen and Spitz contributed further to this subject by providing histological criteria for their differentiation of juvenile melanoma from malignant melanoma. In a male-dominated field, Dr Spitz faced significant barriers to her professional advancement, and much of her groundbreaking work was initially met with scepticism. However, her persistence and dedication to the field led to the eventual acceptance and widespread adoption of her diagnostic criteria for Spitz naevus. Her contributions provided clarity in a complex area of dermatopathology, directly influencing the way dermatologists approached the diagnosis and treatment of pigmented skin lesions. Restoring Dr Sophie Spitz to her rightful place in dermatological history recognizes her as a trailblazer whose work has had a lasting impact on the practice of dermatopathology. Revisiting her contributions ensures that her legacy continues to inspire and inform contemporary dermatology, encouraging future generations to build on the foundation she established.