Clinical and dermoscopic features of Spitz naevus by sex, age and anatomical site: a study of 913 Spitz naevi

Scalvenzi, Massimiliano; Costa, Cláudia; Salvatores, Gaia De Fata; Cappello, Milena; Villani, Alessia

doi:10.1111/bjd.16564

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…In adults, a Spitz nevus is usually dark in color with brown to black papules, nodules, and nodes (12)(13)(14). Because of the difficulty of the clinical diagnosis of Spitz nevus, histopathological examination is necessary (15,16). Therefore, patients should be asked for a detailed medical history, and lesions in younger patients should be differentiated from congenital nevomelanocytic nevus and Spitz nevus.…”

Section: Discussionmentioning

confidence: 99%

A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series

Zheng

et al. 2021

Front. Med.

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Purpose: Melanocytic nevi are common cutaneous lesions. This study aimed to demonstrate the concordance and discordance between clinical and histopathological diagnoses of melanocytic nevi and the importance of histological evaluation in differentiating malignant lesions from diseases with similar clinical manifestations.Patients and Methods: We studied 4,561 consecutive patients with a clinical diagnosis of melanocytic nevi from 2014 to 2019. We compared the clinical diagnosis with the histopathological diagnosis to establish a histopathological concordance rate and then investigated the effects of clinical characteristics and the reasons for removal on misclassification.Results: Among 4,561 patients who were clinically diagnosed with melanocytic nevi, the overall histopathological concordance rate was 82.11% (3,745 of 4,561 patients), while the histopathological discordance rate was 17.89% (816 of 4,561 patients). The histopathological concordance included 90.25% common acquired melanocytic nevi (3,380 of 3,745 patients) and 9.75% other benign melanocytic neoplasms (365 of 3,745 patients). The most common diagnostic change was to seborrheic keratosis (n = 470, 10.30%), followed by basal cell carcinoma (n = 64, 1.40%), vascular tumor (n = 53, 1.16%), fibroma (n = 43, 0.94%), epidermoid cyst (n = 34, 0.75%), wart (n = 30, 0.66%), melanoma (n = 24, 0.53%), Bowen's disease (n = 16, 0.35%), squamous cell carcinoma (n = 4, 0.09%), keratoacanthoma (n = 2, 0.04%), and other neoplasms (n = 76, 1.67%). Male sex, old age, location of the lesion, and the reasons for removal have a potential effect on misclassification. The percentages of misclassified lesions on the trunk and limbs and the perineum and buttocks were higher than those in lesions without a change in diagnosis. Importantly, locations of lesions on the head and neck were significantly related to a change in diagnosis to non-melanoma skin cancer, while locations on the hands and feet were significantly related to a change in diagnosis to melanoma. In addition to a typical clinical features, removal due to lesion changes or repeated stimulation was significantly associated with a change in diagnosis to melanoma.Conclusions: Our study emphasizes the clinical differential diagnosis of melanocytic nevi, especially the possibility of malignant tumors. The occurrence of clinical features associated with clinicopathological discordance should raise the clinical suspect and be carefully differentiated from malignant tumors.

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Section: Discussionmentioning

confidence: 99%

A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series

Zheng

et al. 2021

Front. Med.

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“…thought to be underdiagnosed in Black patients. [5][6][7][8][9][10][11][12][13][14]17,18,[20][21][22][23][24][25][26][27][28][29][30][31][32] Some studies have focused on characterizing Spitz lesions in Hispanic and Black patients. 10,29 Incidence of SN in the predominantly Caucasian countries of the United States, Australia, and the United Kingdom has been reported as 7, 1.66, and 1.4 per 100,000 persons per year and as <1 in the predominantly Asian country Korea.…”

Section: Discussionmentioning

confidence: 99%

“…Fitzpatrick score was assessed by predisposition to burn or tan, and 74.5% of Spitz patients surveyed reported Type I‐III. Meta‐analysis suggests Spitz neoplasms most commonly occur in Caucasians; however, Spitz lesions have traditionally been studied in majority Caucasian cohorts and are thought to be underdiagnosed in Black patients 5‐14,17,18,20‐32 . Some studies have focused on characterizing Spitz lesions in Hispanic and Black patients 10,29 .…”

Section: Discussionmentioning

confidence: 99%

“…The data and literature suggest a slight predominance of spitzoid proliferation in females, with a ratio close to 1.4:1; however, this has been reported as high as 3:1, particularly after age 10–15 years. 6 , 7 , 10 , 12 , 18 , 20 , 21 , 22 , 23 , 24 …”

Section: Discussionmentioning

confidence: 99%

“…Meta‐analysis suggests Spitz neoplasms most commonly occur in Caucasians; however, Spitz lesions have traditionally been studied in majority Caucasian cohorts and are thought to be underdiagnosed in Black patients. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 17 , 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 Some studies have focused on characterizing Spitz lesions in Hispanic and Black patients. 10 , 29 Incidence of SN in the predominantly Caucasian countries of the United States, Australia, and the United Kingdom has been reported as 7, 1.66, and 1.4 per 100,000 persons per year and as <1 in the predominantly Asian country Korea.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for the development of Spitz neoplasms

Benton

Roth

Khan

et al. 2022

Pediatric Dermatology

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It is well recognized that Spitz neoplasms, though featuring histologic similarities to conventional melanoma cytologic atypia, confluent and expansile nesting, pagetoid spread, and mitotic activity, have distinct clinical and genomic characteristics compared to conventional nevi and melanomas, and the vast majority have indolent clinical behavior. 1 While most conventional nevi and melanomas are driven by UV-induced point mutations in genes such as BRAF or NRAS, many Spitz neoplasms are the result of chromosomal structural rearrangements in genes such as ALK, ROS1, NTRK1/3, BRAF, RET, and MAP3K8 among others, or harbor HRAS mutations, and these variants underlie the most recent WHO definition of Spitz neoplasms. [2][3][4] Overall, there are few studies investigating epidemiologic risk factors associated with the development of spitzoid neoplasms, hence risk factors for these tumors remain poorly understood, limiting clinical identification of patients more likely to develop spitzoid neoplasms. We constructed a patient survey focused on demographics, environmental exposures, medical history, and family history to investigate risk factors for Spitz neoplasms and performed a meta-analysis of relevant literature.

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Dermatological Conditions of the Foot and Leg

Jarrett¹

2020

Neale's Disorders of the Foot and Ankle

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Clinical and dermoscopic features of Spitz naevus by sex, age and anatomical site: a study of 913 Spitz naevi

Cited by 6 publications

References 6 publications

A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series

A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series

Risk factors for the development of Spitz neoplasms

Dermatological Conditions of the Foot and Leg

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