Castelli Riccardo, Salvi Ilaria, Trave Ilaria, Viglizzo Gianmaria, Guadagno Antonio, Cabiddu Francesco, Riva Silvia, Parodi Aurora, Cozzani Emanuele
Section of Dermatology, DISSAL, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Section of Dermatology, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Dermatol Pract Concept. 2025 Jul 31;15(3):5401. doi: 10.5826/dpc.1503a5401.
Spitzoid lesions are a group of melanocytic tumors, including Spitz nevi, atypical Spitz tumors, and Spitz melanomas, that pose a considerable diagnostic challenge.
Our aim was to describe the clinical, dermoscopic, and histopathological characteristics of spitzoid melanocytic lesions in adult patients in our center and to find possible associations between certain clinical-dermoscopic characteristics and the diagnosis of melanoma.
We conducted a single-center retrospective study and included all cases of histopathologically-confirmed spitzoid melanocytic lesions diagnosed in adult patients between January 2012 and December 2022. We collected patient demographic characteristics and clinical, dermoscopic, and histopathological characteristics of the studied lesions.
Histopathological examinations of the 103 lesions included in the study revealed four Spitz melanomas (3.9%) and 99 non-melanomas, of which 92 were Spitz nevi (89.3%) and seven atypical Spitz tumors (6.8%). The association between lower limb localization and diagnosis of melanoma was statistically significant (4/4 vs 45/99 patients, P=0.048). A statistically significant association between raised and pigmented morphology and malignant histology was found (4/4 vs 37/99 lesions, P=0.0229). Dermoscopy revealed that a multicomponent pattern was significantly associated with a diagnosis of melanoma (100% vs 21.6%, P<0.01) and that a vascular pattern was significantly associated with atypical Spitz tumors (80% vs 28.8%, P=0.0343).
In our cohort, some clinical characteristics (lower limb location, greater size, pigmentation, and palpability) and dermoscopic patterns (multicomponent) were associated with a diagnosis of melanoma. Dermatologists should be careful whenever they encounter any spitzoid-looking lesions in adults, especially in cases of older patients.
Spitzoid病变是一组黑素细胞肿瘤，包括Spitz痣、非典型Spitz肿瘤和Spitz黑色素瘤，它们带来了相当大的诊断挑战。
我们的目的是描述我们中心成年患者中Spitzoid黑素细胞病变的临床、皮肤镜和组织病理学特征，并找出某些临床-皮肤镜特征与黑色素瘤诊断之间可能的关联。
我们进行了一项单中心回顾性研究，纳入了2012年1月至2022年12月期间成年患者中组织病理学确诊的所有Spitzoid黑素细胞病变病例。我们收集了患者的人口统计学特征以及所研究病变的临床、皮肤镜和组织病理学特征。
该研究纳入的103个病变的组织病理学检查显示有4例Spitz黑色素瘤（3.9%）和99例非黑色素瘤，其中92例为Spitz痣（89.3%），七例为非典型Spitz肿瘤（6.8%）。下肢部位与黑色素瘤诊断之间的关联具有统计学意义（4/4对45/99例患者，P=0.048）。发现隆起和色素沉着形态与恶性组织学之间存在统计学显著关联（4/4对37/99个病变，P=0.0229）。皮肤镜检查显示，多成分模式与黑色素瘤诊断显著相关（100%对21.6%，P<0.01），血管模式与非典型Spitz肿瘤显著相关（80%对28.8%，P=0.0343）。
在我们的队列中，一些临床特征（下肢部位、更大尺寸、色素沉着和可触及性）和皮肤镜模式（多成分）与黑色素瘤诊断相关。皮肤科医生在遇到成人中任何看起来像Spitzoid的病变时应格外小心，尤其是在老年患者中。
