First Department of Dermatology, Aristotle University, Thessaloniki, Greece.
State Clinic of Dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece.
G Ital Dermatol Venereol. 2019 Aug;154(4):457-465. doi: 10.23736/S0392-0488.19.06294-1. Epub 2019 Feb 14.
Since their first description by Sophie Spitz, Spitz nevi have been a subject of controversy among clinicians for many decades, and remain a clinical conundrum until today as their etiology, morphology, biological behavior and natural evolution is still not totally clear. This is because their clinical, dermoscopic and histopathologic features sometimes overlap with those of melanoma, rendering the management of spitzoid lesions particularly difficult. In addition, cases of histopatologically equivocal lesions do exist and their classification might sometimes be very challenging. Among several terms that have been used to describe these morphologically "intermediate" lesions, atypical Spitz tumor (AST) is the most widely used. The aim of this review paper was to describe the dermoscopic patterns and structures seen in Spitz/Reed nevi, spitzoid melanoma and AST. Finally, this article provides an evidence-based update on the available options for the management of spitzoid lesions, before and after histopathologic diagnosis.
自 Sophie Spitz 首次描述以来，Spitz 痣在几十年里一直是临床医生争论的话题，直到今天，它们的病因、形态、生物学行为和自然演变仍不完全清楚。这是因为它们的临床、皮肤镜和组织病理学特征有时与黑色素瘤重叠，使得 Spitz 样病变的管理特别困难。此外，确实存在组织学上有疑问的病变，其分类有时可能非常具有挑战性。在用于描述这些形态上“中间”病变的几个术语中，非典型 Spitz 肿瘤（AST）是最常用的。本文的目的是描述 Spitz/Reed 痣、Spitz 样黑色素瘤和 AST 中可见的皮肤镜模式和结构。最后，本文在组织病理学诊断前后，就 Spitz 样病变的治疗选择提供了基于证据的最新信息。
