Objective: To achieve a clinicopathologic classification of Spitz nevi by comparing their clinical, dermoscopic, and histopathologic features. Design: Eighty-three cases were independently reviewed by3histopathologistsandpreliminarily classified into classic or desmoplastic Spitz nevus(CDSN,n=11), pigmented Spitznevus(PSN,n=14),Reednevus(RN,n=16), or atypical Spitz nevus (ASN, n=14); the remaining 28 cases were thenplaced intoanintermediate category(pigmentedSpitz- Reednevus,PSRN)becauseaunanimousdiagnosis of either PSN or RN was not reached. Setting: University dermatology and pathology departments and general hospital pathology departments. Patients: A sample of subjects with excised melanocytic lesions. Main Outcome Measure: Frequency of dermoscopic patterns within the different histopathologic subtypes of Spitz nevi. Results: Overlapping clinical, dermoscopic, and histopathologic findings were observed among PSN, RN, and PSRN, thereby justifying their inclusion into the single PSRN diagnostic category. Asymmetry was the most frequent indicator of histopathologic ASN (79%; n=11); in only 4 cases did dermoscopic asymmetry show no histopathologic counterpart, and in those cases the discrepancy was probably the result of an artifact of the gross sampling technique carried out with no attention to the dermoscopic features. Conclusions: Among Spitz nevi, histopathologic distinction between PSN and RN is difficult, not reproducible, and may be clinically useless. A simple clinicopathologic classification of these neoplasms might therefore be structured as CDSN, PSRN, and ASN. Asymmetry should be assessed using both dermoscopic and histopathologic analysis, and reliability in histopathologic diagnosis may be enhanced by the simultaneous evaluation of the corresponding dermoscopic images.

The spectrum of Spitz nevi: a clinicopathologic study of 83 cases / Ferrara, G; Argenziano, G; Soyer, Hp; Chimenti, S; Di Blasi, A; Pellacani, G; Peris, K; Piccolo, D; Rubegni, P; Seidenari, S; Staibano, Stefania; Zalaudek, I; DE ROSA, Gaetano. - In: ARCHIVES OF DERMATOLOGY. - ISSN 0003-987X. - STAMPA. - 141:11(2005), pp. 1381-1387.

The spectrum of Spitz nevi: a clinicopathologic study of 83 cases

STAIBANO, STEFANIA;DE ROSA, GAETANO
2005

Abstract

Objective: To achieve a clinicopathologic classification of Spitz nevi by comparing their clinical, dermoscopic, and histopathologic features. Design: Eighty-three cases were independently reviewed by3histopathologistsandpreliminarily classified into classic or desmoplastic Spitz nevus(CDSN,n=11), pigmented Spitznevus(PSN,n=14),Reednevus(RN,n=16), or atypical Spitz nevus (ASN, n=14); the remaining 28 cases were thenplaced intoanintermediate category(pigmentedSpitz- Reednevus,PSRN)becauseaunanimousdiagnosis of either PSN or RN was not reached. Setting: University dermatology and pathology departments and general hospital pathology departments. Patients: A sample of subjects with excised melanocytic lesions. Main Outcome Measure: Frequency of dermoscopic patterns within the different histopathologic subtypes of Spitz nevi. Results: Overlapping clinical, dermoscopic, and histopathologic findings were observed among PSN, RN, and PSRN, thereby justifying their inclusion into the single PSRN diagnostic category. Asymmetry was the most frequent indicator of histopathologic ASN (79%; n=11); in only 4 cases did dermoscopic asymmetry show no histopathologic counterpart, and in those cases the discrepancy was probably the result of an artifact of the gross sampling technique carried out with no attention to the dermoscopic features. Conclusions: Among Spitz nevi, histopathologic distinction between PSN and RN is difficult, not reproducible, and may be clinically useless. A simple clinicopathologic classification of these neoplasms might therefore be structured as CDSN, PSRN, and ASN. Asymmetry should be assessed using both dermoscopic and histopathologic analysis, and reliability in histopathologic diagnosis may be enhanced by the simultaneous evaluation of the corresponding dermoscopic images.
2005
The spectrum of Spitz nevi: a clinicopathologic study of 83 cases / Ferrara, G; Argenziano, G; Soyer, Hp; Chimenti, S; Di Blasi, A; Pellacani, G; Peris, K; Piccolo, D; Rubegni, P; Seidenari, S; Staibano, Stefania; Zalaudek, I; DE ROSA, Gaetano. - In: ARCHIVES OF DERMATOLOGY. - ISSN 0003-987X. - STAMPA. - 141:11(2005), pp. 1381-1387.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/371875
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