The spectrum of Spitz nevi: a clinicopathologic study of 83 cases.
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.
Ferrara
Gerardo
G
Pathologic Anatomy Service, Gaetano Rummo General Hospital, Benevento, Italy.
Argenziano
Giuseppe
G
Soyer
H Peter
HP
Chimenti
Sergio
S
Di Blasi
Arturo
A
Pellacani
Giovanni
G
Peris
Ketty
K
Piccolo
Domenico
D
Rubegni
Pietro
P
Seidenari
Stefania
S
Staibano
Stefania
S
Zalaudek
Iris
I
De Rosa
Gaetano
G
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