title: Clinical characteristics associated with Spitz nevi and Spitzoid malignant melanomas: the Yale University Spitzoid Neoplasm Repository experience, 1991 to 2008.
abstract: BACKGROUND
  Spitz nevi and Spitzoid malignant melanomas are uncommon and may be difficult to distinguish histopathologically. Identification of clinical features associated with these lesions may aid in diagnosis.
  
  
  OBJECTIVE
  We sought to identify clinical characteristics associated with Spitz nevi and Spitzoid malignant melanomas.
  
  
  METHODS
  We conducted a retrospective cohort study of Spitz nevi and Spitzoid malignant melanomas from the Yale University Spitzoid Neoplasm Repository diagnosed from years 1991 through 2008. Descriptive statistics and multivariate logistic regression were used to compare select patient- and tumor-level factors associated with each lesion.
  
  
  RESULTS
  Our cohort included 484 Spitz nevi and 54 Spitzoid malignant melanomas. Spitz nevi were more common (P = .03) in females (65%; n = 316) compared with Spitzoid malignant melanomas (50%; n = 27), occurred more frequently in younger patients (mean age at diagnosis 22 vs 55 years; P < .001), and more likely presented as smaller lesions (diameter 7.6 vs 10.5 mm; P < .001). Increasing age (odds ratio 1.16, 95% CI [1.09, 1.14]; P< .001) and male gender (odds ratio 2.77, 95% CI [1.17, 6.55]; P< .02) predicted Spitzoid malignant melanoma diagnosis.
  
  
  CONCLUSIONS
  Small sample size, unmeasured confounding, and restriction to a single institution may limit the accuracy and generalizability of our findings.
  
  
  CONCLUSIONS
  Age and gender help predict diagnosis of Spitz nevi and Spitzoid malignant melanomas.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut; Section of Dermatology, Veterans Administration Connecticut Healthcare System, West Haven, Connecticut.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Lott
authors.affiliation: Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors.forename: Jade
authors.initials: J
authors.lastname: Wititsuwannakul
authors.affiliation: University of Southern California, Keck School of Medicine, Los Angeles, California.
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Yale Cancer Center, New Haven, Connecticut; Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Stephan
authors.initials: S
authors.lastname: Ariyan
authors.affiliation: Yale Cancer Center, New Haven, Connecticut; Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Deepak
authors.initials: D
authors.lastname: Narayan
authors.affiliation: Yale Cancer Center, New Haven, Connecticut; Section of Medical Oncology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Harriet H
authors.initials: HH
authors.lastname: Kluger
authors.affiliation: Yale Cancer Center, New Haven, Connecticut; Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut. Electronic address: rossitza.lazova@yale.edu.
authors.forename: Rossitza
authors.initials: R
authors.lastname: Lazova
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D018332:Nevus, Epithelioid and Spindle Cell / Q000473:pathology*; D011237:Predictive Value of Tests; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult
keywords: Spitz nevus; Spitzoid malignant melanoma; Yale Spitzoid Neoplasm Repository; clinical characteristics; diagnosis; epidemiology