Viglizzo Gianmaria, Herzum Astrid, Gariazzo Lodovica, Garibeh Ehab, Occella Corrado
Dermatology Unit, Pediatric Hospital IRCSS Giannina Gaslini, Genoa, Italy.
Dermatol Reports. 2023 Jun 6;15(3):9642. doi: 10.4081/dr.2023.9642. eCollection 2023 Sep 12.
Spitzoid lesions are challenging melanocytic lesions comprising benign, intermediate, and malignant lesions. In this study, we aimed to analyze the diagnostic accuracy of clinical and dermatoscopical evaluations of pediatric spitzoid ear lesions. We collected and analyzed, clinically, dermatoscopically, and histologically, pediatric spitzoid ear lesions. We also conducted a systematic review of the literature. At the Pediatric Hospital Gaslini, excision and histopathological evaluation were performed on eight cases: 87.5% of the lesions were consistent with Spitz nevus (SN), and 12.5% with atypical Spitz tumor (AST). Notably, multiple (≥2) dermatoscopical irregularities were present in 5 of 7 SN (71%), yet none were found in AST (0%, 0/1) (Fisher's exact test, P=0.375). From systematic research in the literature, 9 patients were included in this review. At histology, 88.9% were SN and 11% AST. Remarkably, also in the literature, multiple dermatoscopical irregularities were present in most SN (75%, 6/8), but not in the identified AST (0%, 0/1) (P=0.3333). We present a monocentric study on pediatric spitzoid ear lesions. Importantly, dermatoscopical irregularities were not significantly associated with AST, neither in our series nor in the reviewed literature (respectively P=0.375 and P=0.3333), supporting the fact that relying only on the dermatoscopical aspect of spitzoid lesions is not accurate enough for the special site of the ear, where dermatoscopy could actually be misleading.
斯皮茨样病变是具有挑战性的黑素细胞性病变，包括良性、中间型和恶性病变。在本研究中，我们旨在分析小儿耳部斯皮茨样病变临床及皮肤镜评估的诊断准确性。我们收集并从临床、皮肤镜及组织学方面分析了小儿耳部斯皮茨样病变。我们还对文献进行了系统综述。在加斯利尼儿童医院，对8例病例进行了切除及组织病理学评估：87.5%的病变符合斯皮茨痣（SN），12.5%符合非典型斯皮茨肿瘤（AST）。值得注意的是，7例SN中有5例（71%）存在多个（≥2个）皮肤镜下不规则表现，而AST中未发现此类情况（0%，0/1）（Fisher精确检验，P = 0.375）。从文献的系统研究中，本综述纳入了9例患者。组织学检查显示，88.9%为SN，11%为AST。同样值得注意的是，在文献中，大多数SN（75%，6/8）也存在多个皮肤镜下不规则表现，但在已识别的AST中未发现（0%，0/1）（P = 0.3333）。我们展示了一项关于小儿耳部斯皮茨样病变的单中心研究。重要的是，无论是在我们的系列研究中还是在综述文献中，皮肤镜下不规则表现与AST均无显著相关性（分别为P = 0.375和P = 0.3333），这支持了仅依靠斯皮茨样病变的皮肤镜表现对于耳部这一特殊部位不够准确的观点，在该部位皮肤镜实际上可能会产生误导。
