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Both clinically and histopathologically, melanoma of childhood is a rarely encountered lesion. In addition, it has particular histopathologic diagnostic problems. Differential diagnosis of this lesion and Spitz nevus is at times very problematic, in that distant metastases and death of the patient may be the only diagnostic criteria for some cases. We present a 4-year-old girl with an atypical melanocytic neoplasm with Spitzoid features on the left subscapular region.