Clinical and dermoscopic features of atypical Spitz tumors: A multicenter, retrospective, case-control study - 15/10/15

Doi : 10.1016/j.jaad.2015.08.018

Elvira Moscarella, MD ^a, Aimilios Lallas, MD ^a, Athanassios Kyrgidis, MD ^a, Gerardo Ferrara, MD ^b, Caterina Longo, MD ^a, Massimiliano Scalvenzi, MD, PhD ^c, Stefania Staibano, MD, PhD ^d, Cristina Carrera, MD ^e, M.Alba Díaz, MD ^e, Paolo Broganelli, MD ^f, Carlo Tomasini, MD ^f, Stefano Cavicchini, MD ^g, Raffaele Gianotti, MD ^h, Susana Puig, MD ^e,ⁱ, Josep Malvehy, MD ^e,ⁱ, Pedro Zaballos, MD ^j, Giovanni Pellacani, MD ^k, Giuseppe Argenziano, MD ^l,^⁎
^a Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy
^b Department of Oncology, Anatomic Pathology Unit, Gaetano Rummo General Hospital, Benevento, Italy
^c Department of Dermatology, University of Naples Federico II, Naples, Italy
^d Department of Biomedical Advanced Sciences, Pathology Section, School of Medicine, University of Naples Federico II, Naples, Italy
^e Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain
^f City of Health and Science of Turin, University of Turin, Turin, Italy
^g Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
^h Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
ⁱ CIBER of Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
^j Department of Dermatology, Hospital Sant Pau i Santa Tecla, Tarragona, Spain
^k Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
^l Dermatology Unit, Second University of Naples, Naples, Italy

^∗Reprint requests: Giuseppe Argenziano, MD, Dermatology Unit, Second University of Naples, Via Pansini 5, 80131 Naples, Italy.

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.

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Key words : atypical Spitz tumor, dermoscopy, histopathology, melanoma, skin cancer, Spitz nevus

Plan

Methods

Results

Discussion

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.

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Vol 73 - N° 5

P. 777-784 - novembre 2015 Retour au numéro

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Clinical and dermoscopic features of atypical Spitz tumors: A multicenter, retrospective, case-control study - 15/10/15

Abstract

Background

Objective

Methods

Results

Limitations

Conclusion

Plan

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