Elvira Moscarella1, Aimilios Lallas1, Athanassios Kyrgidis1, Gerardo Ferrara2, Caterina Longo1, Massimiliano Scalvenzi3, Stefania Staibano4, Cristina Carrera5, M Alba Díaz5, Paolo Broganelli6, Carlo Tomasini6, Stefano Cavicchini7, Raffaele Gianotti8, Susana Puig9, Josep Malvehy9, Pedro Zaballos10, Giovanni Pellacani11, Giuseppe Argenziano12. 1. Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy. 2. Department of Oncology, Anatomic Pathology Unit, Gaetano Rummo General Hospital, Benevento, Italy. 3. Department of Dermatology, University of Naples Federico II, Naples, Italy. 4. Department of Biomedical Advanced Sciences, Pathology Section, School of Medicine, University of Naples Federico II, Naples, Italy. 5. Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain. 6. City of Health and Science of Turin, University of Turin, Turin, Italy. 7. Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 8. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. 9. Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain; CIBER of Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain. 10. Department of Dermatology, Hospital Sant Pau i Santa Tecla, Tarragona, Spain. 11. Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. 12. Dermatology Unit, Second University of Naples, Naples, Italy. Electronic address: g.argenziano@gmail.com.
Abstract
BACKGROUND: Few studies have described the clinical and dermoscopic features of atypical Spitz tumors. OBJECTIVE: We sought to describe the clinical and dermoscopic features of a series of atypical Spitz tumors as compared with those of conventional Spitz nevi. METHODS: This was a multicenter, retrospective, case-control study, analyzing the clinical and dermoscopic characteristics of 55 atypical Spitz tumors and 110 Spitz nevi that were excised and diagnosed histopathologically. RESULTS: The majority of atypical Spitz tumors presented clinically as a plaque or nodule, dermoscopically typified by a multicomponent or nonspecific pattern. A proportion of lesions (16.4%) exhibited the typical nonpigmented Spitzoid pattern of dotted vessels and white lines under dermoscopy. Nodularity, ulceration, linear vessels, polymorphic vessels, white lines, and blue-white veil were associated with atypical Spitz tumors by univariate analysis, but only nodularity and white lines remained significant after multivariate analysis. In contrast, a pigmented typical Spitzoid pattern was a potent predictor of Spitz nevi, associated with 6.5-fold increased probability. LIMITATIONS: Differentiation from Spitzoid melanoma and other nonmelanocytic lesions was not investigated. CONCLUSION: Atypical Spitz tumors are polymorphic melanocytic proliferations with a nodular clinical appearance. Dermoscopically they demonstrate a multicomponent and nonspecific pattern. A typical nonpigmented Spitzoid pattern on dermoscopy (with dotted vessels and white lines) does not exclude atypical Spitz tumors.
BACKGROUND: Few studies have described the clinical and dermoscopic features of atypical Spitz tumors. OBJECTIVE: We sought to describe the clinical and dermoscopic features of a series of atypical Spitz tumors as compared with those of conventional Spitz nevi. METHODS: This was a multicenter, retrospective, case-control study, analyzing the clinical and dermoscopic characteristics of 55 atypical Spitz tumors and 110 Spitz nevi that were excised and diagnosed histopathologically. RESULTS: The majority of atypical Spitz tumors presented clinically as a plaque or nodule, dermoscopically typified by a multicomponent or nonspecific pattern. A proportion of lesions (16.4%) exhibited the typical nonpigmented Spitzoid pattern of dotted vessels and white lines under dermoscopy. Nodularity, ulceration, linear vessels, polymorphic vessels, white lines, and blue-white veil were associated with atypical Spitz tumors by univariate analysis, but only nodularity and white lines remained significant after multivariate analysis. In contrast, a pigmented typical Spitzoid pattern was a potent predictor of Spitz nevi, associated with 6.5-fold increased probability. LIMITATIONS: Differentiation from Spitzoid melanoma and other nonmelanocytic lesions was not investigated. CONCLUSION:Atypical Spitz tumors are polymorphic melanocytic proliferations with a nodular clinical appearance. Dermoscopically they demonstrate a multicomponent and nonspecific pattern. A typical nonpigmented Spitzoid pattern on dermoscopy (with dotted vessels and white lines) does not exclude atypical Spitz tumors.
Authors: Giuseppe Argenziano; H Peter Soyer; Sergio Chimenti; Renato Talamini; Rosamaria Corona; Francesco Sera; Michael Binder; Lorenzo Cerroni; Gaetano De Rosa; Gerardo Ferrara; Rainer Hofmann-Wellenhof; Michael Landthaler; Scott W Menzies; Hubert Pehamberger; Domenico Piccolo; Harold S Rabinovitz; Roman Schiffner; Stefania Staibano; Wilhelm Stolz; Igor Bartenjev; Andreas Blum; Ralph Braun; Horacio Cabo; Paolo Carli; Vincenzo De Giorgi; Matthew G Fleming; James M Grichnik; Caron M Grin; Allan C Halpern; Robert Johr; Brian Katz; Robert O Kenet; Harald Kittler; Jürgen Kreusch; Josep Malvehy; Giampiero Mazzocchetti; Margaret Oliviero; Fezal Ozdemir; Ketty Peris; Roberto Perotti; Ana Perusquia; Maria Antonietta Pizzichetta; Susana Puig; Babar Rao; Pietro Rubegni; Toshiaki Saida; Massimiliano Scalvenzi; Stefania Seidenari; Ignazio Stanganelli; Masaru Tanaka; Karin Westerhoff; Ingrid H Wolf; Otto Braun-Falco; Helmut Kerl; Takeji Nishikawa; Klaus Wolff; Alfred W Kopf Journal: J Am Acad Dermatol Date: 2003-05 Impact factor: 11.527
Authors: Gerardo Ferrara; Giuseppe Argenziano; H Peter Soyer; Sergio Chimenti; Arturo Di Blasi; Giovanni Pellacani; Ketty Peris; Domenico Piccolo; Pietro Rubegni; Stefania Seidenari; Stefania Staibano; Iris Zalaudek; Gaetano De Rosa Journal: Arch Dermatol Date: 2005-11
Authors: R L Barnhill; Z B Argenyi; L From; L F Glass; J C Maize; M C Mihm; M S Rabkin; S G Ronan; W L White; M Piepkorn Journal: Hum Pathol Date: 1999-05 Impact factor: 3.466
Authors: D W Bartenstein; J M Fisher; C Stamoulis; C Weldon; J T Huang; S E Gellis; M G Liang; B Schmidt; E B Hawryluk Journal: Br J Dermatol Date: 2019-02-10 Impact factor: 9.302