Cramer emphasizes in his letter the importance of analyzing the histogenesis of Spitz nevi and was interested in gaining more details concerning the lesions that were analyzed in our study.1 Interestingly, all 5 Spitz nevi were larger than ordinary acquired nevi and on histologic analysis showed congenital-type features with well-developed adnexal/vascular relationships and involvement of the reticular dermis. However, we have no information if the lesions were present at birth or if they were "acquired." I could not agree more with the fact that the term acquired is not clearly defined, since congenital nevi may not be visible at the time of birth, as stated in the letter by Cramer.
Bogdan I, Burg G, Boni R. Molecular and Cellular Pathogenesis of Spitz Nevi—Reply. Arch Dermatol. 2002;138(9):1255. doi:10.1001/archderm.138.9.1251