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Kelati A, Oqbani K, Chiheb S. Atypical Verrucous Presentation of Spitz Nevus. Dermatol Pract Concept 2023; 13:dpc.1301a46. [PMID: 36892352 PMCID: PMC9946098 DOI: 10.5826/dpc.1301a46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Awatef Kelati
- Dermatology department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.,Member of the International Dermoscopy Society Task Force of dark skin's imaging.,Non-invasive skin imaging group of the French Society of Dermatology.,Non-invasive skin imaging group of the Moroccan Society of Dermatology
| | - Kenza Oqbani
- Pathology department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Soumia Chiheb
- Dermatology department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
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2
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LALLAS A, PASCHOU E, MANOLI SM, PAPAGEORGIOU C, SPYRIDIS I, LIOPYRIS K, BOBOS M, MOUTSOUDIS A, LAZARIDOU E, APALLA Z. Dermatoscopy of melanoma according to type, anatomic site and stage. Ital J Dermatol Venerol 2021; 156:274-288. [DOI: 10.23736/s2784-8671.20.06784-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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3
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Valdivielso-Ramos M, Roldan D, Alonso S. Verrucous Spitz Nevus. J Pediatr 2020; 226:307-308. [PMID: 32663592 DOI: 10.1016/j.jpeds.2020.07.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - David Roldan
- Pathology Department, Infanta Leonor Hospital, Madrid, Spain
| | - Soledad Alonso
- Pathology Department, Infanta Leonor Hospital, Madrid, Spain
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4
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Kawana H, Fujita H, Fujisawa D, Ishii M, Murata M, Kurumatani A, Hayama K, Tanaka M, Terui T. Spitz nevus with unusual dermoscopic figures in an adult female. Clin Case Rep 2020; 8:1007-1009. [PMID: 32577253 PMCID: PMC7303874 DOI: 10.1002/ccr3.2801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/18/2020] [Accepted: 02/11/2020] [Indexed: 11/12/2022] Open
Abstract
Spitz nevus is an important differential diagnosis of malignant melanoma, especially in young adults. This case provides a significant information about unusual dermoscopic features of adult Spitz nevus, which may reflect changes over the years.
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Affiliation(s)
- Hironori Kawana
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Hideki Fujita
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Daisuke Fujisawa
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Madoka Ishii
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Miwa Murata
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Ayano Kurumatani
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Koremasa Hayama
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
| | - Masaru Tanaka
- Department of DermatologyTokyo Women’s Medical University Medical Center EastTokyoJapan
| | - Tadashi Terui
- Division of Dermatological ScienceDepartment of DermatologyNihon University School of MedicineTokyoJapan
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5
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Fernandez-Flores A, Cassarino DS. Chondroid atypical spitzoid melanocytic tumor. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2019; 52:190-193. [PMID: 31213260 DOI: 10.1016/j.patol.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/28/2019] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
Chondroid stromal change is very rare in melanocytic nevi. We present a severely atypical symmetrical Spitz tumor on the right arm of a 24-years-old man. It showed maturation and occasional mitotic figures. The melanocytes were intermingled with cartilaginous stroma. The Ki67 proliferative rate was 5%. It was weakly positive for p16 and negative for BRAF/V600E. BAP1 expression was preserved. PCR for Myriad myPath® Melanoma test was also negative.
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Affiliation(s)
- Angel Fernandez-Flores
- Consultant Histopathologist, Hospital El Bierzo, Cellular Pathology, Ponferrada, Spain; Biomedical Investigation Institute of A Coruña, CellCOM-ST Group, A Coruña, Spain; Consultant Histopathologist, Hospital de la Reina, Cellular Pathology, Ponferrada, Spain.
| | - David S Cassarino
- Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente, Department of Dermatology, Los Angeles, CA, USA
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6
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Bartenstein DW, Fisher JM, Stamoulis C, Weldon C, Huang JT, Gellis SE, Liang MG, Schmidt B, Hawryluk EB. Clinical features and outcomes of spitzoid proliferations in children and adolescents. Br J Dermatol 2019; 181:366-372. [PMID: 30467833 DOI: 10.1111/bjd.17450] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Spitzoid proliferations range from Spitz naevi to melanomas. There are few studies describing clinical features and outcomes in the paediatric population. OBJECTIVES To determine the clinical features and outcomes of a large paediatric cohort with histopathologically confirmed Spitz tumours. METHODS This was a retrospective cohort study of patients seen at Boston Children's Hospital who were aged < 20 years and had a histopathological diagnosis of spitzoid proliferation from 1 January 1994 to 23 October 2012. RESULTS In total 595 patients with 622 spitzoid proliferations were identified (median age 7·4 years, interquartile range 4·6-11·7). Overall 512 proliferations (82·3%) were typical, 107 (17·2.%) were atypical and three (0·5%) were melanomas. The median ages at biopsy were 7·4, 7·2 and 17·2 years, respectively, and there was a significant difference in age at biopsy for patients with typical or atypical proliferations vs. melanoma (P < 0·01). Among samples with positive margins (n = 153), 55% (54 of 98) of typical proliferations, 77% (41 of 53) of atypical proliferations and 100% (two of two) of melanomas were re-excised. Six patients had sentinel lymph node biopsy performed, with three patients demonstrating nodes positive for melanocytic cells. Within a median follow-up of 4·1 years for the full cohort there were no related deaths. CONCLUSIONS Spitz tumours have strikingly benign outcomes in the paediatric population, although this study is limited by the low number of melanomas and restriction to a single paediatric institution. Aggressive management recommendations should be reconsidered for children and adolescents with banal-appearing Spitz naevi, based on the clinically indolent behaviour in this cohort.
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Affiliation(s)
- D W Bartenstein
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Department of Dermatology, Massachusetts General Hospital, Boston, MA, 02114, U.S.A.,Tufts University School of Medicine, Boston, MA, 02111, U.S.A.,Dermatology Program, Boston Children's Hospital, Boston, MA, 02115, U.S.A
| | - J M Fisher
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Dermatology Program, Boston Children's Hospital, Boston, MA, 02115, U.S.A
| | - C Stamoulis
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Division of Adolescent Medicine, Boston Children's Hospital, Boston, MA, 02115, U.S.A
| | - C Weldon
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Department of Surgery, Boston Children's Hospital, Boston, MA, 02115, U.S.A.,Department of Pediatric Oncology, Dana Farber Cancer Institute, Boston, MA, 02215, U.S.A
| | - J T Huang
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Dermatology Program, Boston Children's Hospital, Boston, MA, 02115, U.S.A.,Department of Pediatric Oncology, Dana Farber Cancer Institute, Boston, MA, 02215, U.S.A
| | - S E Gellis
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Dermatology Program, Boston Children's Hospital, Boston, MA, 02115, U.S.A
| | - M G Liang
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Dermatology Program, Boston Children's Hospital, Boston, MA, 02115, U.S.A
| | - B Schmidt
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Department of Pathology, Boston Children's Hospital, Boston, MA, 02115, U.S.A
| | - E B Hawryluk
- Harvard Medical School, Boston, MA, 02115, U.S.A.,Department of Dermatology, Massachusetts General Hospital, Boston, MA, 02114, U.S.A.,Dermatology Program, Boston Children's Hospital, Boston, MA, 02115, U.S.A
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7
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Yu J, Jen MV, Yan AC, Elenitsas R, Rubin AI. Angiomatoid and desmoplastic Spitz nevus presenting as a keloidal nodule. Pediatr Dermatol 2018; 35:e228-e230. [PMID: 29582459 DOI: 10.1111/pde.13479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Angiomatoid and desmoplastic Spitz nevi are rare histologic variants of Spitz nevi that present most frequently on the extremities of children and young adults. Although Spitz nevi are clinically heterogeneous, one presenting as a keloidal nodule has not been previously published. We present a case of an angiomatoid and desmoplastic Spitz nevus clinically akin to a keloid on an African-American teenager and describe its unique histopathologic features.
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Affiliation(s)
- JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Melinda V Jen
- Department of Pediatrics, Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Albert C Yan
- Department of Pediatrics, Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rosalie Elenitsas
- Department of Dermatology, Division of Dermatopathology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Adam I Rubin
- Department of Pediatrics, Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Dermatology, Division of Dermatopathology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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8
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Woltsche N, Schmid-Zalaudek K, Deinlein T, Rammel K, Hofmann-Wellenhof R, Zalaudek I. Abundance of the benign melanocytic universe: Dermoscopic-histopathological correlation in nevi. J Dermatol 2018; 44:499-506. [PMID: 28447347 DOI: 10.1111/1346-8138.13808] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/28/2017] [Indexed: 11/28/2022]
Abstract
The broad universe of "melanocytic nevi" includes a variety of different subtypes, which can be classified either due to their morphology, epidemiology, genetic alterations or risk for developing melanoma. Regarding morphology, on the one hand macroscopic/clinical and on the other hand histopathological appearance were used to subdivide in the past, often resulting in confusion and poor interobserver agreement, while nowadays dermoscopy presents the clinician's precious bridge between naked-eye examination and histopathological diagnostics, allowing prediction of the lesions' histopathology, follow up and monitoring over time without need of excision. The non-invasive dermoscopic examination relies on the assessment of colors, patterns and the distribution of both within a cutaneous lesion. Until today, the correspondence of certain dermoscopic colors and patterns to certain histopathological correlates has been reported for a huge amount of different cutaneous lesions. Moreover, the correspondence of certain dermoscopic features to certain body sites, age groups and pigmentary traits, but also to specific genetic alterations in lesions, has been broadly investigated. Dermoscopy has led us to a new understanding of melanocytic nevi's biology and evolution and, last but not least, to a new classification system, which we want to present herein.
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Affiliation(s)
- Nora Woltsche
- Department of Ophthalmology, Medical University of Graz, Graz, Austria
| | | | - Teresa Deinlein
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Katrin Rammel
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | | | - Iris Zalaudek
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
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9
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Lallas A, Apalla Z, Ioannides D, Lazaridou E, Kyrgidis A, Broganelli P, Alfano R, Zalaudek I, Argenziano G. Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society. Br J Dermatol 2017; 177:645-655. [PMID: 28118479 DOI: 10.1111/bjd.15339] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 01/23/2023]
Abstract
Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical recognition, biological behaviour and management strategies. Although Spitz naevi are considered benign tumours, their clinical and dermoscopic morphological overlap with spitzoid melanoma renders the management of spitzoid lesions particularly difficult. The controversy deepens because of the existence of tumours that cannot be safely histopathologically diagnosed as naevi or melanomas (atypical Spitz tumours). The dual objective of the present study was to provide an updated classification on dermoscopy of Spitz naevi, and management recommendations of spitzoid-looking lesions based on a consensus among experts in the field. After a detailed search of the literature for eligible studies, a data synthesis was performed from 15 studies on dermoscopy of Spitz naevi. Dermoscopically, Spitz naevi are typified by three main patterns: starburst pattern (51%), a pattern of regularly distributed dotted vessels (19%) and globular pattern with reticular depigmentation (17%). A consensus-based algorithm for the management of spitzoid lesions is proposed. According to it, dermoscopically asymmetric lesions with spitzoid features (both flat/raised and nodular) should be excised to rule out melanoma. Dermoscopically symmetric spitzoid nodules should also be excised or closely monitored, irrespective of age, to rule out atypical Spitz tumours. Dermoscopically symmetric, flat spitzoid lesions should be managed according to the age of the patient. Finally, the histopathological diagnosis of atypical Spitz tumour should warrant wide excision but not a sentinel lymph-node biopsy.
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Affiliation(s)
- A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Z Apalla
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - D Ioannides
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - E Lazaridou
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Reggio Emilia, Italy
| | - P Broganelli
- City of Health and Science University, Turin, Italy
| | - R Alfano
- Department of Anaesthesiology, Surgery and Emergency Medicine, Second University of Naples, Naples, Italy
| | - I Zalaudek
- Department of Dermatology and Venereology, Nonmelanoma Skin Cancer Unit, Medical University of Graz, Austria
| | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
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10
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Rawson R, Robbins E, McCarthy SW, Scolyer RA. Angiomatoid Spitz naevus: novel observations and clues to diagnosis of a rare variant. Pathology 2016; 48:739-742. [PMID: 27780602 DOI: 10.1016/j.pathol.2016.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/12/2016] [Accepted: 08/19/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Robert Rawson
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Melanoma Institute Australia, Sydney, NSW, Australia.
| | - Elizabeth Robbins
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Stanley W McCarthy
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Melanoma Institute Australia, Sydney, NSW, Australia; Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Richard A Scolyer
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Melanoma Institute Australia, Sydney, NSW, Australia; Discipline of Pathology, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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11
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Fernandez-Flores A, Cassarino DS. Unusual Histopathological Patterns in Melanocytic Nevi With Some Previously Undescribed Patterns. Am J Dermatopathol 2016; 38:167-85. [PMID: 26894768 DOI: 10.1097/dad.0000000000000381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Melanocytic nevi are one of the most common diagnoses in the daily practice of any dermatopathologist. Although in the vast majority of cases the final diagnosis is not difficult, there are certain rare and unusual morphologic variations that can elicit some diagnostic problems. Although some of these variations can be considered as mere morphologic oddities, others might lead to a differential diagnosis with melanoma, or with other tumors, including epithelial or neural tumors. In the current report, we review many of these morphologic variations and discuss the main differential diagnosis, when appropriate.
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Affiliation(s)
- Angel Fernandez-Flores
- *Consultant Histopathologist, Department of Cellular Pathology, Hospital El Bierzo, Ponferrada, Spain; and †Consultant Dermatopathologist, Department of Pathology, Southern California Kaiser Permanente, Los Angeles Medical Center (LAMC), Los Angeles, CA
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12
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Malkan AD, Sandoval JA. Controversial tumors in pediatric surgical oncology. Curr Probl Surg 2014; 51:478-520. [PMID: 25524425 DOI: 10.1067/j.cpsurg.2014.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 11/17/2014] [Indexed: 12/13/2022]
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