Spitz nevi in adults should be closely monitored. Dermoscopy is the preferred method of in vivo imaging of melanocytic nevi and may provide clues for high-risk lesions. However, there is not a perfect match between the dermoscopic image of an individual nevus, the evolution of its change, and its histopathology. We present a case of a rapidly (over months) changing and growing nevus in an adult patient with dermoscopy suggesting a melanoma but eventually with a histology of a Spitz nevus with an accompanying immune reaction.