title: Likelihood of finding melanoma when removing a Spitzoid-looking lesion in patients aged 12 years or older.
abstract: BACKGROUND
  Dermoscopy improves the recognition of melanoma and Spitz nevus but occasionally melanoma may exhibit a symmetric pattern mimicking Spitz nevus.
  
  
  OBJECTIVE
  We sought to investigate the likelihood of finding melanoma when excising a symmetric Spitzoid-looking lesion in patients aged 12 years or older.
  
  
  METHODS
  This study included patients aged 12 years or older with symmetric, Spitzoid-looking lesions that were diagnosed histopathologically as Spitz nevus or melanoma. Demographic, clinical, and dermoscopic variables were included in the analysis. We used χ(2) for nonparametric comparisons. Crude odds ratios and 95% confidence intervals were calculated by univariate logistic regression.
  
  
  RESULTS
  Of 384 included lesions, 333 (86.7%) were histopathologically diagnosed as Spitz nevus and 51 (13.3%) as melanoma. The risk of melanoma significantly increased with increasing age, being 50% or higher after the age of 50 years.
  
  
  CONCLUSIONS
  Limitations are retrospective design, exclusion of patients younger than 12 years, lack of detailed histopathologic data, and limited sample size.
  
  
  CONCLUSIONS
  Our results confirm the observation that melanoma may be dermoscopically indistinguishable from Spitz nevi, strongly suggesting that the only safe strategy not to miss melanoma is to excise all Spitzoid-looking lesions in patients aged 12 years or older.
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova Instituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy. Electronic address: emlallas@gmail.com.
authors.forename: Aimilios
authors.initials: A
authors.lastname: Lallas
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova Instituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Moscarella
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova Instituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova Instituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy.
authors.forename: Athanassios
authors.initials: A
authors.lastname: Kyrgidis
authors.affiliation: Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: de Mestier
authors.affiliation: University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Vale
authors.affiliation: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Guida
authors.affiliation: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellacani
authors.affiliation: Skin Cancer Unit, Arcispedale Santa Maria Nuova Instituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Reggio Emilia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D046169:Dermoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D018332:Nevus, Epithelioid and Spindle Cell / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult
keywords: Reed nevus; Spitz nevus; dermoscopy; diagnosis; management; melanoma