title: Spitz nevus in a Hispanic population: a clinicopathological study of 130 cases.
abstract: Spitz nevus is an uncommon melanocytic nevus distinctive by its epithelioid and spindled melanocytes. Many studies have attempted to characterize Spitz nevus, but none of them in a Hispanic population. Our aim is to characterize the clinical and histopathological presentation of the Spitz nevus in a Hispanic population. A retrospective study was carried out from our files that included those cases histopathologically diagnosed as Spitz nevus. A blinded examination was performed to evaluate the histopathological characteristics of 130 lesions. The demographics of the patients, the anatomic location, and the accuracy of the clinical diagnosis were analyzed. Eighty-one females and 49 males (ratio of 1.7:1) were included in the study. The mean age was 18.8 years. Overall, the most common location was the lower extremities (41%), followed by the upper extremities (27%), trunk (16%), and head and neck (16%). The nevi followed a similar anatomic distribution in females and males. The lesions were clinically diagnosed with accuracy in 20% of the cases and characterized as a pigmented papule in 42% of the cases. Upon histopathological evaluation, most nevi exhibited symmetry (84%), were well circumscribed (91%), and exhibited epidermal hyperplasia (69%). The junctional type was seen in 42% of the cases, the compound type in 38%, and the dermal type in 20%. Sixty-eight percent of nevi were mostly composed of epithelioid melanocytes, the spindled-shaped melanocytes predominated in 17% of cases, and 12% were composed of both epithelioid and spindled-shaped melanocytes. Multinucleated melanocytes were seen in 7% of nevi, mostly in the epithelioid Spitz nevus (67%). Abundant melanin was observed in 51 cases, from which the most common variant was the classic Spitz nevi. The typical dull eosinophilic globules (Kamino bodies) were observed in a minority of the cases (11%), mostly in the classic Spitz nevus. The most common variant was the classic Spitz nevus (65%), followed by the dermal Spitz nevus (15%). In conclusion, Spitz nevus in a Hispanic population most commonly presents as a pigmented papule on the lower extremities irrespective of sex and age. It is characterized by a melanocytic proliferation most commonly composed of nested epithelioid melanocytes in a junctional or compound arrangement, with the presence of abundant melanin.
authors.affiliation: From the *Division of Dermatopathology, University of Texas Medical Branch, Galveston, TX; and †Department of Dermatology, School of Medicine, University of Puerto Rico, San Juan, PR.
authors.forename: Alma C
authors.initials: AC
authors.lastname: Berlingeri-Ramos
authors.forename: Adisbeth
authors.initials: A
authors.lastname: Morales-Burgos
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Sánchez
authors.forename: Elena M
authors.initials: EM
authors.lastname: Nogales
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D002648:Child; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D008543:Melanins / Q000378:metabolism; D008544:Melanocytes / Q000378:metabolism / Q000473:pathology; D018332:Nevus, Epithelioid and Spindle Cell / Q000208:ethnology / Q000378:metabolism / Q000473:pathology*; D011647:Puerto Rico / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000208:ethnology / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D008543:Melanins