Original articleClinical and dermoscopic features of atypical Spitz tumors: A multicenter, retrospective, case-control study
Section snippets
Methods
We conducted a multicenter, case-control study analyzing clinical and dermoscopic characteristics of 55 atypical Spitz tumors and 110 Spitz nevi that were excised and diagnosed histopathologically. Clinical and dermoscopic images of atypical Spitz tumors were collected from the databases of 7 pigmented lesions clinics in Italy (Reggio Emilia, Naples, Modena, Turin, Milan) and Spain (Barcelona, Tarragona). The inclusion criterion was the availability of a clinical and dermoscopic image of a
Results
In all, 165 patients (65 male and 100 female) were included. Mean age was 28.4 ± 13.5 years for female and 26.4 ± 31.9 years for male patients. Mean age was 20.8 ± 13.8 years in the atypical Spitz tumors group, and 31.0 ± 12.3 years in the Spitz nevi group (Student t test, P < .0001).
Frequencies of the observed clinical and dermoscopic variables are reported in Tables II and III .
The majority of atypical Spitz tumors presented as nodular lesions (32/55, 58.2%), whereas Spitz nevi were more
Discussion
Our study provides novel insights into the clinical and dermoscopic morphology of atypical Spitz tumors, as compared with Spitz nevi. According to our findings, atypical Spitz tumors develop either as pigmented nodular lesions with a multicomponent or unspecific pattern dermoscopically, or as nonpigmented nodular lesions with a typical Spitzoid pattern on dermoscopy. In contrast, detection of a pigmented typical Spitzoid pattern (the so-called starburst pattern) is highly suggestive of Spitz
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2018, Journal of the American Academy of DermatologyCitation Excerpt :Likewise, a relatively symmetric lesion suspected to be a Spitz nevus or nevus of Reed in younger patients with SWSs may still be a candidate for clinical monitoring depending on other clinical parameters (Fig 4). The presence of SWSs organized as orthogonal lines is 1 pattern of SWSs that can be seen in spitzoid neoplasms.14,21,22 All our melanoma cases with SWSs had 2 or more additional melanoma-specific dermoscopic features.
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2018, Journal of the American Academy of DermatologyCitation Excerpt :Dermoscopic specific features were scored as present or absent. For the global dermoscopic pattern classification, we integrated criteria from pattern analysis,12 from a study on nevus-associated melanomas13 and from a study of atypical spitzoid tumors.14 This culminated in use of the following descriptive patterns: (1) multicomponent pattern (>2 dermoscopic structures [reticular, globular, or homogeneous]), asymmetrically distributed; (2) nevus-like pattern (≤2 dermoscopic structures [reticular, globular, or homogeneous]), symmetrically distributed; (3) pink spitzoid pattern (hypomelanotic or amelanotic tumors with a diffuse vascular pattern); (4) pigmented Reed-like pattern (starburst pattern of streaks or large globules at the periphery); and (5) nonclassifiable nodules (exophytic tumors not attributable to any of the aforementioned categories).
Supported in part by the Italian Ministry of Health (RF-2010-2316524). Research at the Melanoma Unit in Hospital Clinic Barcelona is partially funded by grants 03/0019, 05/0302, 06/0265, 09/1393, and 12/00840 from Fondo de Investigaciones Sanitarias, Spain; by the CIBER de Enfermedades Raras of the Instituto de Salud Carlos III (Fondo Investigaciones Sanitarias FIS numbers 09/01393 and 12/00840), Spain; by the Agencia de Gestio d'Ajuts Universitaris i Recerca numbers AGAUR 2009 SGR 1337 and AGAUR 2014_SGR_603 of the Catalan Government, Spain; by the European Commission under the 6th Framework Programme, Contract No: LSHC-CT-2006-018702 (through GenoMEL); and by the National Cancer Institute of the US National Institutes of Health (CA83115). The sponsors had no role in the design and conduct of the study; in the collection, analysis and interpretation of data; or in the preparation, review, or approval of the manuscript.
Conflicts of interest: None declared.