Spitz naevus: a proposal for management

Abstract

References1 Friboes W. Beitrag zur Klinik und Histopathologie der gutartigen Hautepitheliome . S. Karger-Verlag, Berlin, 1912. 2 Kleine-Natrop HE. Simultaneous generalization of benign basalioma of both Spiegler and Brooke types. Arch Klin Exp Dermatol 1959; 209 : 45 -55. 3 Volter C, Baier G, Schwager K et al. Cylindrocarcinoma in a patient with Brooke-Spiegler syndrome. Laryngorhinootologie 2002; 81 : 243 -246. 4 Durani BK, Kurzen H, Jaeckel A et al. Malignant transformation of multiple dermal cylindromas. Br J Dermatol 2001; 145 : 653 -656. 5 Pizinger K, Michal M. Malignant cylindroma in Brooke-Spiegler syndrome. Dermatology 2000; 201 : 255 -257. 6 McKee PH, Fletcher CD, Stavrino P, Pambakian H. Carcinosarcoma arising in eccrine spiradenoma. Am J Dermatopathol 1990; 12 : 335 -343. 7 Grouls V, Iwaszkiewicz J, Berndt R. Malignes ekkrines Spiradenom. Z Hautkr 1991; 66 : 892-895. 8 Meriggi F, Tagliabo R, Morone G et al. The potential malignancy of eccrine spiradenoma. Ital J Surg Sci 1989; 19 : 265 -268. 9 Biernat W, Peraud A, Wozniak L, Ohgaki H. P53 mutations in sweat gland carcinomas. Int J Cancer 1998; 76 : 317 -320. 10 Mutoh H, Nagata H, Ohno K et al. Analysis of the p53 gene in parotid gland cancers: a relatively high frequency of mutations in low-grade mucoepidermoid carcinomas. Int J Oncol 2001; 18 : 781-786. References 1 Hull PR, D'Arcy C. Isotretinoin use and subsequent depression and suicide: presenting the evidence. Am J Clin Dermatol 2003; 4: 493 -505. 2 Bremner JD. Does isotretinoin cause depression and suicide? Psychopharmacol Bull 2003; 37: 64 -78. 3 O'Connell KA, Wilkin JK, Pitts M. Isotretinoin (Accutane) and serious psychiatric adverse events. J Am Acad Dermatol 2003; 48: 306 -308. 4 Chu A, Cunliffe WJ. The inter-relationship between isotretinoin/ acne and depression. J Eur Acad Dermatol Venereol 2003; 17: 619. 5 Gupta MA. Incidence of psychiatric disorders in dermatological patients. J Eur Acad Dermatol Venereol 2003; 17: 624 -626. 6 Jacobs DG, Deutsch N, Brewer M. Suicide, depression, and isotretinoin: is there a causal link? J Am Acad Dermatol 2001; 45: S168 -S175. 7 Wysowski DK, Pitts M, Beitz J. An analysis of reports of depression and suicide in patients treated with isotretinoin. J Am Acad Dermatol 2001; 45: 515 -519. 8 Jick SS, Kremers HM, Vasilakis-Scaramozza C. Isotretinoin use and risk of depression, psychotic symptoms, suicide, and attempted suicide.

Pediatric Atypical Spitzoid Neoplasms: A Review with Emphasis on ‘Red’ (‘Spitz’) Tumors and ‘Blue’ (‘Blitz’) Tumors

“…Needless to say, since SN can be considered as potentially showing all the dermoscopic features of melanoma and vice versa, surgical excision is also recommended for lesions clinically resembling SN in patients older than 12, regardless of the presence of atypical clinical/dermoscopic features [1,2,16,17,18]. The flow chart provided in figure 3 summarizes the main rules for the management of melanocytic neoplasms with clinical and dermoscopic spitzoid features.…”

“…A pigmented SN appearing up to the age of 12 years can be easily diagnosed and managed conservatively if it is relatively small, is not clinically atypical and shows a nonatypical (globular, starburst, reticular or homogeneous) dermoscopic pattern [1,17]. Under these circumstances, a follow-up can be scheduled with controls every 3–6 months [17].…”

“…Under these circumstances, a follow-up can be scheduled with controls every 3–6 months [17]. In the absence of dramatic/unexpected changes in color, shape or size, such a follow-up protocol can be held until the appearance of a homogeneous brown pattern, which is probably the pattern of an ‘ancient’ pigmented SN [15,17]; since then, a 1-year follow-up can be employed; the complete involution of the lesion over years will be eventually documented [18]. …”

Spitz Nevus: Follow-Up Study of 8 Cases of Childhood Starburst Type and Proposal for Management

“…All patients should be managed on an individual basis and efforts should be made to avoid both overly aggressive and suboptimal management strategies [16]. Only through rigorous clinical and dermoscopic characterization of SNi and long-term follow-up of patients, will we be able to have truly objective information about these lesions.…”

Natural Evolution of Spitz Nevi

“…Spitz nevi usually presents as solitary, pink-to-red plaques or nodules, but pigmented Spitz nevi are also commonly seen. Dermoscopy has contributed significantly to improving the clinical diagnosis of pigmented and nonpigmented Spitz nevi and, more recently, digital dermoscopic follow-up has allowed a better understanding of the evolution of this peculiar group of nevi [3,4,5,6,7]. …”