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Basal cell carcinoma

Distinguished by its pearly appearance, telangiectasias, and potential for ulceration, features not typical of a Spitz naevus.

Cutaneous B cell lymphoma

Presents as firm, violaceous or 'plum-colored' nodules or plaques, unlike the typically pink or red papule of a Spitz naevus.

Dermatofibroma

A firm dermal nodule that exhibits the 'dimple sign' (retraction with lateral pressure), which is not a feature of a Spitz naevus.

Haemangioma

A vascular lesion (like a cherry angioma) that is bright red and compressible, but lacks the melanocytic features seen on dermoscopy of a Spitz naevus.

Intradermal naevus

Typically a soft, flesh-colored or lightly pigmented papule in adults, lacking the rapid growth and pink/red color often seen in a Spitz naevus in children.

Melanoma

The most important differential, often distinguished by asymmetry, irregular borders, color variegation, and evolution, though biopsy is essential for definitive diagnosis.

Poroma

A benign sweat gland tumor, usually appearing as a solitary pink or red papule on the palms or soles, a different typical location.

Seborrhoiec keratosis

Has a warty, greasy, 'stuck-on' appearance, which is distinct from the smooth, dome-shaped Spitz naevus.

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