title: Clinical and dermoscopic features of atypical Spitz tumors: A multicenter, retrospective, case-control study.
abstract: BACKGROUND
  Few studies have described the clinical and dermoscopic features of atypical Spitz tumors.
  
  
  OBJECTIVE
  We sought to describe the clinical and dermoscopic features of a series of atypical Spitz tumors as compared with those of conventional Spitz nevi.
  
  
  METHODS
  This was a multicenter, retrospective, case-control study, analyzing the clinical and dermoscopic characteristics of 55 atypical Spitz tumors and 110 Spitz nevi that were excised and diagnosed histopathologically.
  
  
  RESULTS
  The majority of atypical Spitz tumors presented clinically as a plaque or nodule, dermoscopically typified by a multicomponent or nonspecific pattern. A proportion of lesions (16.4%) exhibited the typical nonpigmented Spitzoid pattern of dotted vessels and white lines under dermoscopy. Nodularity, ulceration, linear vessels, polymorphic vessels, white lines, and blue-white veil were associated with atypical Spitz tumors by univariate analysis, but only nodularity and white lines remained significant after multivariate analysis. In contrast, a pigmented typical Spitzoid pattern was a potent predictor of Spitz nevi, associated with 6.5-fold increased probability.
  
  
  CONCLUSIONS
  Differentiation from Spitzoid melanoma and other nonmelanocytic lesions was not investigated.
  
  
  CONCLUSIONS
  Atypical Spitz tumors are polymorphic melanocytic proliferations with a nodular clinical appearance. Dermoscopically they demonstrate a multicomponent and nonspecific pattern. A typical nonpigmented Spitzoid pattern on dermoscopy (with dotted vessels and white lines) does not exclude atypical Spitz tumors.
authors.affiliation: Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Moscarella
authors.affiliation: Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Aimilios
authors.initials: A
authors.lastname: Lallas
authors.affiliation: Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Athanassios
authors.initials: A
authors.lastname: Kyrgidis
authors.affiliation: Department of Oncology, Anatomic Pathology Unit, Gaetano Rummo General Hospital, Benevento, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.affiliation: Dermatology and Skin Cancer Unit, First Medical Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Longo
authors.affiliation: Department of Dermatology, University of Naples Federico II, Naples, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Scalvenzi
authors.affiliation: Department of Biomedical Advanced Sciences, Pathology Section, School of Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Staibano
authors.affiliation: Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Carrera
authors.affiliation: Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain.
authors.forename: M Alba
authors.initials: MA
authors.lastname: Díaz
authors.affiliation: City of Health and Science of Turin, University of Turin, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Broganelli
authors.affiliation: City of Health and Science of Turin, University of Turin, Turin, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Tomasini
authors.affiliation: Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cavicchini
authors.affiliation: Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Gianotti
authors.affiliation: Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain; CIBER of Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Puig
authors.affiliation: Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain; CIBER of Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Malvehy
authors.affiliation: Department of Dermatology, Hospital Sant Pau i Santa Tecla, Tarragona, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Zaballos
authors.affiliation: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pellacani
authors.affiliation: Dermatology Unit, Second University of Naples, Naples, Italy. Electronic address: g.argenziano@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Argenziano
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D046169:Dermoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D018332:Nevus, Epithelioid and Spindle Cell / Q000473:pathology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult
keywords: Spitz nevus; atypical Spitz tumor; dermoscopy; histopathology; melanoma; skin cancer