BRAF mutations are common events in a variety of melanocytic nevi and primary 
cutaneous melanomas. We have previously found BRAF mutations in 82% of nevi, 
consisting of congenital, common acquired and dysplastic types, and 33% of 
primary cutaneous melanomas other than the spitzoid type, similar to other 
published reports. A small number of studies have evaluated Spitz nevi and have 
failed to detect any lesions possessing a BRAF mutation. Only one study included 
categories of atypical Spitz nevus and borderline lesions suspected to be 
spitzoid melanomas, along with classic Spitz nevi and spitzoid melanomas. We 
examined a spectrum of spitzoid lesions that included 48 Spitz nevi, some with 
atypical features, seven atypical (borderline) Spitz tumors, and 13 spitzoid 
melanomas. BRAF mutations were detected in 12 of 68 spitzoid lesions, of which 
two were spitzoid melanomas and 10 were Spitz nevi. Five of the 10 Spitz nevi 
with BRAF mutations were altered by more than usual cytologic atypia and/or 
architectural atypia overlapping with dysplastic nevi, or 
irritation/inflammation; one desmoplastic Spitz nevus had a BRAF mutation. These 
results indicate that a small subset of Spitz nevi, some with atypical 
histologic features, possess BRAF mutations. Therefore, the BRAF mutational 
status does not separate all Spitz nevi from spitzoid melanomas and non-Spitz 
types of melanocytic proliferations, contrary to previous reports.