Pedrosa Ana F, Lopes Jose M, Azevedo Filomena, Mota Alberto
Department of Dermatology and Venereology, Centro Hospitalar São João EPE, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.
Faculty of Medicine, University of Porto, Porto, Portugal; Department of Pathology, Centro Hospitalar São João EPE, Porto, Portugal.
Dermatol Pract Concept. 2016 Apr 30;6(2):37-41. doi: 10.5826/dpc.0602a07. eCollection 2016 Apr.
Spitz/Reed nevi are melanocytic lesions that may mimic melanoma at clinical, dermatoscopic and histopathological levels. Management strategies of these lesions remain controversial.
We aim a correlation among clinical-dermatoscopic and histological features of a series of Spitz/Reed nevi diagnosed during 7 years at the Department of Dermatology.
Clinical, dermatoscopic and histological features of Spitz/Reed nevi diagnosed at our tertiary hospital from 2008 to 2014 were reviewed in order to seek correlation.
All described dermatoscopic patterns for Spitz/Reed nevi were found among the 47 enrolled patients; starburst and atypical/multicomponent patterns prevailed (57.4%). Reticular pattern predominated among children younger than 12 years, whereas homogeneous pattern was more frequent in patients older than 12 years, although these differences were not statistically significant (P=0.785). Among histological atypical lesions, all dermatoscopic patterns were represented, but the atypical/multicomponent predominated (56.3%). Two out of 11 dermatoscopically atypical lesions did not show histopathological counterpart.
The excision of Spitz/Reed nevi in adults is supported, given the inability to accurately predict those with histopathological atypia, based on clinical and dermatoscopic features, which may raise concern about malignancy.
斯皮茨/里德痣是黑素细胞性病变,在临床、皮肤镜和组织病理学层面可能酷似黑色素瘤。这些病变的处理策略仍存在争议。
我们旨在研究在皮肤科7年间诊断的一系列斯皮茨/里德痣的临床、皮肤镜和组织学特征之间的相关性。
回顾了2008年至2014年在我们三级医院诊断的斯皮茨/里德痣的临床、皮肤镜和组织学特征,以寻找相关性。
在47例入选患者中发现了所有已描述的斯皮茨/里德痣的皮肤镜模式;星芒状和非典型/多成分模式占主导(57.4%)。网状模式在12岁以下儿童中占主导,而均匀模式在12岁以上患者中更常见,尽管这些差异无统计学意义(P = 0.785)。在组织学非典型病变中,所有皮肤镜模式均有表现,但非典型/多成分模式占主导(56.3%)。11例皮肤镜非典型病变中有2例未显示组织病理学对应表现。
鉴于无法根据临床和皮肤镜特征准确预测组织病理学非典型的斯皮茨/里德痣,这可能引发对恶性肿瘤的担忧,因此支持对成人斯皮茨/里德痣进行切除。