A Case Report on the Dermoscopic Features of Spark's Nevus

Abstract

Spark's nevus is a compound word composed of Spitz nevus and Clark's nevus. It is one of the combined melanocytic nevi which is more common in female and usually presents as a sharp circumscribed hyperpigmented macule on the lower extremities. On histopathologic findings, both cytologic features of Spitz nevus characterized as large spindle or epithelioid melanocytes containing large nuclei with abundant cytoplasm, and architecture of Clark's nevus characterized as elongation of rete ridges, bridging of the nests, concentric and lamellar fibrosis can be seen. A 24-year-old female presented with an asymptomatic, solitary, dark-brown-colored papule surrounded by brownish patch that looked similar to dysplastic nevus or malignant melanoma on the buttock. On dermoscopic examination, it showed brown-to-black globules, diffuse homogenous pigmentation with blue-white structures, and a surrounding brownish reticular pattern that faded away. On histopathologic findings, overall asymmetrical structure, epithelioid large melanocytes containing large nuclei with abundant cytoplasm, and Kamino body were seen in the central portion. Also, lentiginous hyperplasia, bridging of the nests composed of melanocytes containing foamy cytoplasm, concentric and lamellar fibrosis along with the elongation of rete ridge, and perivascular lymphocytic infiltration were seen in the peripheral portion. The diagnosis of Spark's nevus was made. Following its definition, this combined nevus is diagnosed histopathologically, but the clinicodermoscopic features have not been well described. Herein, we report a case of Spark's nevus in which dermoscopy was helpful for differentiating it from malignant melanoma. (Ann Dermatol 32(3) 233∼236, 2020

Clinicopathologic and Dermoscopic Features of 20 Cases of Spark's Nevus, a Dermoscopic Simulator of Melanoma

“…Dermoscopic features of SprkN have been previously described in only few single case reports. Park et al 4 reported a single case that showed brown-to-black globules, diffuse homogenous pigmentation with blue-white structures, brown dots, and isolated eccentric hyperpigmentation. Cimmino et al 3 reported a small series of the lesions characterized by a combined pattern with a central homogeneous blackish and a regular gradient-edged lattice in the peripheries.…”

“…Dermoscopic features of SprkN in a series of cases have not been described yet; only few single case reports are present in the literature. 2–4 We performed an observational retrospective study at our institution to describe clinical and dermoscopic features of SprkN.…”

Spitz Nevus with Features of Clark Nevus, So-Called SPARK Nevus: Case Series Presentation with Emphasis on Cytological and Histological Features

“…At a 10-year follow-up of 12/27 patients, there were no relapses and/or metastases [ 4 ]. After Fernandez-Flores conducted a careful analysis in 2012 on the eponyms and definitions of less-known nevic lesions [ 11 ], in 2018 and 2020 there were authors [ 12 , 13 ] who tried to define the dermoscopic features of the SPARK nevus. Indeed, although the histological criteria allow a fairly certain definition of this entity, greater difficulties exist when trying to understand which dermoscopic characteristics are peculiar to this type of nevus.…”

“…Indeed, although the histological criteria allow a fairly certain definition of this entity, greater difficulties exist when trying to understand which dermoscopic characteristics are peculiar to this type of nevus. Biondo et al [ 12 ], reporting their clinical case, hypothesized that the dermoscopic pattern was quite similar to that of Clark’s nevus, while in the case of Bin J. et al [ 13 ], the lesion clinically presented as a brownish asymmetrical patch with a diameter of 1 cm at the periphery and a well-demarcated dome-shaped papule that was centrally located: it could not be clearly distinguished from either the Clark nevus or a pigmented Spitz nevus. From the histopathological point of view, it is important to make a correct differential diagnosis with a form of dysplastic nevus with severe atypia or with a melanoma, and a careful cytological evaluation of the melanocytes present at the dermal epidermal junction is absolutely mandatory to correctly diagnose this entity without an over- or underdiagnosis [ 1 , 14 ].…”

Vom Hund über die Dermatoskopie zum Spark-Nävus

“…Dermatoskopisch sind in der Literatur bisher 2 Fälle von Spark-Nävi mit atypischem Netzwerk, blauem Schleier und peripheren Globuli beschrieben [17,18]. Ja, auch in der histologischen Diagnostik gibt es Grenzen [8][9][10][11]13].…”