Dermoscopy of Spitz/Reed naevi and management

Papageorgiou, Chryssoula; Apalla, Zoe; Bobos, Mattheos; Gkentsidi, Theodosia; Kyrgidis, Athanassios; Lallas, Konstantinos; Manoli, Sofia-Magdalini; Moutsoudis, Andreas; Nikolaidou, Christina; Spyridis, Ioannis; Lallas, Aimilios

doi:10.23736/s0392-0488.19.06294-1

Cited by 5 publications

(10 citation statements)

References 49 publications

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“…Megaris et al reported different frequencies of global patterns in melanomas with diameters up to 5 mm, including reticular, 57.7%; structureless, 26.9%; mixed (globular and reticular), 11.5%; starburst (spitzoid), 3.8%; and none for globular and multicomponent ones [ 19 ]. Our conclusion is not surprising, as the dermoscopic spitzoid pattern is rarely confirmed by the spitzoid melanoma diagnosis in the histopathological report [ 31 , 32 , 33 , 34 , 35 ]. In our study, no micromelanomas were classified as spitzoid melanomas the in histological report.…”

Section: Discussionsupporting

confidence: 50%

“…In our study, no micromelanomas were classified as spitzoid melanomas the in histological report. The most important consideration, according to studies reported by Lallas et al, is that the probability of a dermoscopically symmetric spitzoid-like lesion being a melanoma depends on the patient’s age: it is extremely low before puberty and gradually increases afterwards—50% after the age of 50 years [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

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Dermoscopy of Small Diameter Melanomas with the Diagnostic Feasibility of Selected Algorithms—A Clinical Retrospective Multicenter Study

Słowińska

Kamińska‐Winciorek

Kowalska-Olędzka³

et al. 2021

Cancers

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Objective: The aim of the study was to verify two hypotheses. The first concerned the possibility of diagnostic dermoscopic differentiation between cutaneous melanomas of the histopathological category in situ (pTis) and thin melanomas (pT1a) in terms of their diameter. The second assessed the diagnostic feasibility of two dermoscopic algorithms aiming to detect ≤ 5.0 mm-sized melanomas histopathologically confirmed as pTis and pT1a. Methods: Dermoscopic images of consecutive cases of histopathologically confirmed melanomas were evaluated by three independent investigators for the presence of the predefined criteria. The melanomas were subdivided according to their diameter into small melanomas, so-called micromelanomas (microM)—sized ≤ 5.0 mm and >5.0 mm, according to published definitions of small melanocytic lesions. The Triage Amalgamated Dermoscopic Algorithm (TADA) and the revisited 7-point checklist of dermoscopy (7-point) algorithm were chosen for the diagnostic feasibility. Odds ratios and corresponding 95% confidence limits (CL) were calculated using the logistic regression adjusted for age for the melanoma-specific dermoscopic structures, the dermoscopic patterns and the diagnostic feasibility of the 7-point checklist and TADA algorithms. The p-values of the results were corrected using the Bonferroni method. Results: In total, 106 patients with 109 melanomas, 50 sized ≤ 5.0 mm and 59 exceeding the diameter of 5.0 mm, were retrospectively analyzed. The prevalent general pattern of microM was the spitzoid one (48% vs. 11.86%, p = 0.0013). Furthermore, 40% of microM vs. 6.78% melanomas sized > 5.0 mm (p = 0.0023) did not present melanoma-specific patterns. The asymmetric multicomponent pattern was present in 64.41% melanomas sized > 5.0 mm and in 26.00% microM (p = 0.0034). The asymmetry of structures or colors was detected in 56% microM vs. 89.83% (p = 0.0020) and 56% microM and 94.92% (p = 0.000034) melanoma sized > 5.0 mm, respectively. The differences in frequency of the detected dermoscopic structures specific to melanomas revealed that microM are almost deprived of negative networks (p = 0.04), shiny white structures (p = 0.0027) and regression features (p = 0.00003). Neither prominent skin markings nor angulated lines were found in the entire study group. Out of the vascular structures, microM presented only dotted (32%) or polymorphous (28%) vessels, although more rarely than melanomas sized > 5.0 mm (66.1% p = 0.017 and 49% p > 0.05, respectively). The diagnostic feasibility revealed a score ≥ 3 of the 7-point algorithm (indicative for malignancy) in 60% microM and 98.31% melanomas sized > 5.0 mm (p = 0.000006). The TADA algorithm revealed melanoma-specific patterns in 64% microM and 96.61% > 5.0 mm-sized melanomas (p = 0.00006) and melanoma-specific structures in 72% and 91.53% (p > 0.05), respectively. Conclusion: In the dermoscopy, 40% of micromelanomas histopathologically staged as pTis and pT1a did not reveal melanoma-specific patterns. Among the general melanocytic patterns, the spitzoid one was the most frequently found in melanomas sized ≤ 5.0 mm. The 7-point checklist and TADA dermoscopic algorithms were helpful in the identification of the majority of melanomas sized ≤ 5.0 mm.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Dermoscopy of Small Diameter Melanomas with the Diagnostic Feasibility of Selected Algorithms—A Clinical Retrospective Multicenter Study

Słowińska

Kamińska‐Winciorek

Kowalska-Olędzka³

et al. 2021

Cancers

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“…Frequencies regarding the other patterns are less consistent between studies, however, in an analysis of 15 dermoscopy studies totaling 896 SN cases, the dotted vessel pattern and globular pattern were found to be the next most frequent dermoscopic patterns seen ( 54 ). Non-pigmented Spitz nevi are commonly associated with the dotted vessel pattern, pigmented Spitz nevi with the globular pattern, and Reed nevus with the starburst pattern ( 56 ). Other dermoscopic features of SN that may be seen include diffuse vessel distribution, regular streaks, regular homogeneous pigmentation, irregular and regular brown globules, atypical network, blue-white veil, and inverse network ( 32 ).…”

Section: Dermoscopymentioning

confidence: 99%

“…SM may exhibit similar dermoscopic features to SN, but in general tends to exhibit more asymmetry and more colors ( 34 , 56 ). Compared to non-spitzoid melanoma, SM are less likely to exhibit a multicomponent dermoscopic pattern, atypical network, structureless areas, dark brown coloration and more likely to exhibit a pink Spitz-like pattern, red/pink and white coloration, shiny white areas, milky red areas, and polymorphous vascular patterns ( 34 ).…”

Section: Dermoscopymentioning

confidence: 99%

The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification

2022

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Spitz tumors represent a distinct subtype of melanocytic lesions with characteristic histopathologic features, some of which are overlapping with melanoma. More common in the pediatric and younger population, they can be clinically suspected by recognizing specific patterns on dermatoscopic examination, and several subtypes have been described. We now classify these lesions into benign Spitz nevi, intermediate lesions identified as “atypical Spitz tumors” (or Spitz melanocytoma) and malignant Spitz melanoma. More recently a large body of work has uncovered the molecular underpinning of Spitz tumors, including mutations in the HRAS gene and several gene fusions involving several protein kinases. Here we present an overarching view of our current knowledge and understanding of Spitz tumors, detailing clinical, histopathological and molecular features characteristic of these lesions.

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“… 6,54,55 The starburst pattern is the most common dermoscopic pattern seen in SN, present in more than 50% of SN and 96% sensitive for SN (Figure 8A). 56 It is indicated by the presence of pseudopods or radial streaming present circumferentially around the growth 57 . Many starburst pattern SN evolve to reticular or homogeneous and then regress 58,59 .…”

Section: Spitz Nevimentioning

confidence: 99%

A practical review of dermoscopy for pediatric dermatology part I: Melanocytic growths

Kaushik

Natsis

Gordon

et al. 2020

Pediatric Dermatology

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The value of dermoscopy in the detection of skin cancer is well established. Less is published on the utility of dermoscopy in the evaluation of pediatric skin disease. Our review (in two parts) aims to serve as an update on pediatric dermoscopy and to provide readers with a practical application for the use of dermoscopy in pediatric dermatology clinics. In part I, we propose a dermoscopy algorithm for pediatric skin disease and melanocytic growths, and in part II, we address vascular growths, common skin infections, and inflammatory conditions for which dermoscopy is valuable.

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Dermoscopy of Spitz/Reed naevi and management

Cited by 5 publications

References 49 publications

Dermoscopy of Small Diameter Melanomas with the Diagnostic Feasibility of Selected Algorithms—A Clinical Retrospective Multicenter Study

Dermoscopy of Small Diameter Melanomas with the Diagnostic Feasibility of Selected Algorithms—A Clinical Retrospective Multicenter Study

The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification

A practical review of dermoscopy for pediatric dermatology part I: Melanocytic growths

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