Melanoacanthoma simulating pigmented spitz nevus: an unusual dermoscopy pitfall.
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.
Rossiello
Luigi
L
Department of Dermatology, Second University of Naples, Naples, Italy.
Zalaudek
Iris
I
Ferrara
Gerardo
G
Docimo
Giovanni
G
Giorgio
Caterina M
CM
Argenziano
Giuseppe
G
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