Likelihood of finding melanoma when removing a Spitzoid-looking lesion in patients aged 12 years or older

Lallas, Aimilios; Moscarella, Elvira; Longo, Caterina; Kyrgidis, Athanassios; Mestier, Yuka de; Vale, Gabrielle; Guida, Stefania; Pellacani, Giovanni; Argenziano, Giuseppe

doi:10.1016/j.jaad.2014.09.037

Cited by 64 publications

(52 citation statements)

References 32 publications

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“…Regardless of these observations, patients with SN appearing at ≥40 years of age did not have a worse prognosis compared to the other age groups. These results were similar to those reported in previous studies . It must be mentioned that the majority of information regarding sun exposure patterns is collected from patients and therefore recall bias may be present.…”

Section: Discussionsupporting

confidence: 91%

Patients with Spitz naevi in the Greek population: Epidemiologic, Clinical and Histopathological characteristics

Soura

Dimitrakopoulou

Christofidou

et al. 2017

Acad Dermatol Venereol

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Section: Discussionsupporting

confidence: 91%

Patients with Spitz naevi in the Greek population: Epidemiologic, Clinical and Histopathological characteristics

Soura

Dimitrakopoulou

Christofidou

et al. 2017

Acad Dermatol Venereol

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“…21–24 As shown by a recent study, the possibility of a perfectly symmetric spitzoid-looking lesion to be a melanoma significantly increases with age, being exceedingly low until the age of 20 years and rising to 50% after the age of 50 years 25 . Conservative management of Spitz nevi in children is increasing, as highlighted by a survey recently published.…”

Section: Discussionmentioning

confidence: 95%

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

Moscarella

Lallas

Kyrgidis

et al. 2015

Journal of the American Academy of Dermatology

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Background Few studies have described the clinical and dermoscopic features of atypical Spitz tumors (AST). Objective To describe the clinical and dermoscopic features of a series of AST as compared to those of conventional Spitz nevi (SN). Methods Multicenter, retrospective, case-control study, analyzing the clinical and dermoscopic characteristics of 55 AST and 110 SN that were excised and diagnosed histopathologically. Results The majority of AST presented clinically as a plaque or nodule, dermoscopically typified by a multicomponent or nonspecific pattern. A proportion of lesions (16.4%) exhibited the typical non pigmented 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 AST 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 SN, associated with 6.5-fold increased probability. Limitations Differentiation from spitzoid melanoma and other non melanocytic 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 non pigmented spitzoid pattern on dermoscopy (with dotted vessels and white lines) does not exclude AST.

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“…SMM may be dermoscopically undistinguishable from SN, with 13.3% of Spitzoid looking lesions in patients >12 years being melanomas . Asymmetry in the Spitzoid pattern corresponding to asymmetrically distributed streaks, pseudopods or globules is considered a melanoma criterion .…”

Section: Introductionmentioning

confidence: 99%

Differential diagnosis of Spitzoid melanocytic neoplasms

Stefanaki

Chardalias

et al. 2016

Acad Dermatol Venereol

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Atypical Spitzoid neoplasms represent a controversial and incompletely defined diagnostic category for lesions with intermediate architecture and cytomorphology between Spitz nevus and melanoma. The vast majority of these neoplasms have a good overall prognosis. Only a small proportion of patients will end up developing distant metastases and death. The distinction between Spitz tumours with atypical features and Spitzoid melanoma remains difficult on clinical and histological grounds and the prediction of the biological behaviour of those tumours even with sentinel lymph node biopsy is impossible. Tools such as immunohistochemistry, genetic analysis, mutation analysis and mass spectometry have contributed to the better understanding of those tumours and may be useful in the differential diagnosis of Spitzoid tumours.

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Likelihood of finding melanoma when removing a Spitzoid-looking lesion in patients aged 12 years or older

Abstract: Our results confirm the observation that melanoma may be dermoscopically indistinguishable from Spitz nevi, strongly suggesting that the only safe strategy not to miss melanoma is to excise all Spitzoid-looking lesions in patients aged 12 years or older.

Cited by 64 publications

References 32 publications

Patients with Spitz naevi in the Greek population: Epidemiologic, Clinical and Histopathological characteristics

Patients with Spitz naevi in the Greek population: Epidemiologic, Clinical and Histopathological characteristics

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

Differential diagnosis of Spitzoid melanocytic neoplasms

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