title: Melanoacanthoma simulating pigmented spitz nevus: an unusual dermoscopy pitfall.
abstract: BACKGROUND
  The starburst pattern is the dermoscopic hallmark of pigmented Spitz nevus, although it has been rarely observed in melanoma as well.
  
  
  OBJECTIVE
  To describe a case of melanoacanthoma simulating pigmented Spitz nevus.
  
  
  METHODS
  Clinical, dermoscopic, and histopathologic examinations were performed for the occurrence of a 4-mm pigmented skin lesion on the hip of a 38-year-old Caucasian woman.
  
  
  RESULTS
  Dermoscopy examination of the lesion disclosed a stereotypical starburst pattern characterized by pigmented streaks symmetrically distributed at the periphery. A preoperative diagnosis of pigmented Spitz nevus was made, and the lesion was excised. However, subsequent histopathologic examination revealed a melanoacanthoma.
  
  
  CONCLUSIONS
  The starburst pattern, although diagnostic for pigmented Spitz nevus, can be rarely observed in other benign or malignant pigmented skin lesions. Accordingly, all lesions in adults exhibiting a starburst pattern or other spitzoid features should be excised for histopathologic evaluation.
authors.affiliation: Department of Dermatology, Second University of Naples, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Rossiello
authors.forename: Iris
authors.initials: I
authors.lastname: Zalaudek
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.forename: Caterina M
authors.initials: CM
authors.lastname: Giorgio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D049309:Acanthoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D046169:Dermoscopy; D005260:Female; D006801:Humans; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology