title: Spitz nevi: In vivo confocal microscopic features, dermatoscopic aspects, histopathologic correlates, and diagnostic significance.
abstract: BACKGROUND
  Spitz nevi are benign melanocytic tumors, sometimes misdiagnosed as malignant melanoma (MM).
  
  
  OBJECTIVE
  We sought identification of characteristic in vivo microscopic features of Spitz nevi, their histopathologic correlates, and diagnostic usefulness.
  
  
  METHODS
  Forty Spitz nevi were studied by in vivo confocal microscopy and dermatoscopy, evaluating histopathologic correlates, and compared with 40 MMs and 40 Clark nevi.
  
  
  RESULTS
  Some histologic aspects characteristic for Spitz nevus diagnosis were correlated with confocal features, comprising some that can be useful for atypical Spitz nevus classification. The most striking features for differentiating Spitz nevi from MMs were the presence of sharp border cut-off, junctional nests, and melanophages.
  
  
  CONCLUSIONS
  No correlates were found for other aspects, such as Kamino bodies, hyperkeratosis, acanthosis, mitoses, and maturation with depth. The impossibility of exploring deeper aspects hampered an accurate distinction from MMs in some cases.
  
  
  CONCLUSIONS
  Confocal and dermatoscopic examination enabled the identification of different Spitz categories with different histologic substrates.
authors.affiliation: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. pellacani.giovanni@unimore.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellacani
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Cesinaro
authors.forename: Sara
authors.initials: S
authors.lastname: Bassoli
authors.forename: Pascale
authors.initials: P
authors.lastname: Guitera
authors.forename: Scott W
authors.initials: SW
authors.lastname: Menzies
authors.forename: Stefania
authors.initials: S
authors.lastname: Seidenari
mesh_terms: D020405:Dermis / Q000473:pathology; D046169:Dermoscopy; D003937:Diagnosis, Differential; D004416:Dysplastic Nevus Syndrome / Q000473:pathology; D004817:Epidermis / Q000473:pathology; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D018613:Microscopy, Confocal; D018332:Nevus, Epithelioid and Spindle Cell / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*