title: The spectrum of Spitz nevi: a clinicopathologic study of 83 cases.
abstract: OBJECTIVE
  To achieve a clinicopathologic classification of Spitz nevi by comparing their clinical, dermoscopic, and histopathologic features.
  
  
  METHODS
  Eighty-three cases were independently reviewed by 3 histopathologists and preliminarily classified into classic or desmoplastic Spitz nevus (CDSN, n = 11), pigmented Spitz nevus (PSN, n = 14), Reed nevus (RN, n = 16), or atypical Spitz nevus (ASN, n = 14); the remaining 28 cases were then placed into an intermediate category (pigmented Spitz-Reed nevus, PSRN) because a unanimous diagnosis of either PSN or RN was not reached.
  
  
  METHODS
  University dermatology and pathology departments and general hospital pathology departments.
  
  
  METHODS
  A sample of subjects with excised melanocytic lesions.
  
  
  METHODS
  Frequency of dermoscopic patterns within the different histopathologic subtypes of Spitz nevi.
  
  
  RESULTS
  Overlapping clinical, dermoscopic, and histopathologic findings were observed among PSN, RN, and PSRN, thereby justifying their inclusion into the single PSRN diagnostic category. Asymmetry was the most frequent indicator of histopathologic ASN (79%; n = 11); in only 4 cases did dermoscopic asymmetry show no histopathologic counterpart, and in those cases the discrepancy was probably the result of an artifact of the gross sampling technique carried out with no attention to the dermoscopic features.
  
  
  CONCLUSIONS
  Among Spitz nevi, histopathologic distinction between PSN and RN is difficult, not reproducible, and may be clinically useless. A simple clinicopathologic classification of these neoplasms might therefore be structured as CDSN, PSRN, and ASN. Asymmetry should be assessed using both dermoscopic and histopathologic analysis, and reliability in histopathologic diagnosis may be enhanced by the simultaneous evaluation of the corresponding dermoscopic images.
authors.affiliation: Pathologic Anatomy Service, Gaetano Rummo General Hospital, Benevento, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argenziano
authors.forename: H Peter
authors.initials: HP
authors.lastname: Soyer
authors.forename: Sergio
authors.initials: S
authors.lastname: Chimenti
authors.forename: Arturo
authors.initials: A
authors.lastname: Di Blasi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellacani
authors.forename: Ketty
authors.initials: K
authors.lastname: Peris
authors.forename: Domenico
authors.initials: D
authors.lastname: Piccolo
authors.forename: Pietro
authors.initials: P
authors.lastname: Rubegni
authors.forename: Stefania
authors.initials: S
authors.lastname: Seidenari
authors.forename: Stefania
authors.initials: S
authors.lastname: Staibano
authors.forename: Iris
authors.initials: I
authors.lastname: Zalaudek
authors.forename: Gaetano
authors.initials: G
authors.lastname: De Rosa
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D046169:Dermoscopy; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D018332:Nevus, Epithelioid and Spindle Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology