title: "White" network in Spitz nevi and early melanomas lacking significant pigmentation.
abstract: BACKGROUND
  Spitz nevi and early melanomas lacking significant pigmentation exhibit overlapping dermoscopic patterns of regularly arranged dotted vessels over a pink background. Although white network has been described in both tumors, little is known about the frequency of this pattern in both tumors.
  
  
  OBJECTIVE
  We sought to compare the frequency of white network in Spitz nevi and early melanomas lacking significant pigmentation and to correlate this feature with histopathology.
  
  
  METHODS
  Two independent dermoscopists scored the presence of white network in a series of retrospectively collected images of histopathologically diagnosed cases of Spitz nevi and melanomas, dermoscopically typified by dotted vessels.
  
  
  RESULTS
  A total of 65 cases including 39 melanomas (median thickness 0.4 mm) and 26 Spitz nevi were analyzed. Patients with Spitz nevi were significantly younger compared to patients with melanoma (mean age: 26.8 vs 51.2 years, respectively; P < .001). The 2 observers scored white network being present in 23 (88.5%) and 24 (92.3%) Spitz nevi compared with 10 (25.6%) and 8 (20.5%) cases of 39 melanomas, respectively (P < .001). Interobserver agreement for white network was good (kappa = 0.67; 95% confidence interval 0.44-0.90). Histopathologically, elongated rete ridges were observed in 22 (88.5%) Spitz nevi and 11 (36.7%) melanomas (P < .001).
  
  
  CONCLUSIONS
  We did not evaluate other dermoscopic-histopathologic correlates commonly seen in Spitz nevi and melanomas in our study.
  
  
  CONCLUSIONS
  Although white network occurs at significantly higher frequency among hypopigmented/amelanotic Spitz nevi compared with early melanoma, it is not exclusively seen in Spitz nevi. Thus, excision of melanocytic tumors showing this pattern is mandatory.
authors: Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy. iris.zalaudek@meduni-graz.at
authors: Iris
authors: I
authors: Zalaudek
authors: Harald
authors: H
authors: Kittler
authors: Rainer
authors: R
authors: Hofmann-Wellenhof
authors: Juergen
authors: J
authors: Kreusch
authors: Caterina
authors: C
authors: Longo
authors: Joseph
authors: J
authors: Malvehy
authors: Susana
authors: S
authors: Puig
authors: Elvira
authors: E
authors: Moscarella
authors: Simonetta
authors: S
authors: Piana
authors: Cesare
authors: C
authors: Massone
authors: Carlo
authors: C
authors: Cota
authors: Gerardo
authors: G
authors: Ferrara
authors: Mariella
authors: M
authors: Fleischer
authors: Giuseppe
authors: G
authors: Argenziano
mesh_terms: D000328:Adult; D000368:Aged; D046169:Dermoscopy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018332:Nevus, Epithelioid and Spindle Cell / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D012880:Skin Pigmentation