Spitz nevus versus atypical Spitz tumor: Objective morphological differentiation by digital dermoscopy analysis

Abstract

Spitzoid melanocytic skin lesions (MSL) include Spitz nevi (SN) and spitzoid melanomas (SM). A third rare subset was described, atypical spitz tumors (AST), that share overlapping histologic features of SN and SM. Being difficult to diagnose lesions, both with dermoscopy and histology, there is considerable uncertainty regarding their biological potential. We aimed to investigate if digital dermoscopy analysis (DDA) could select some significantly different features in 41 dermoscopic images including 19 SN and 21 AST. Stepwise logistic regression analysis was performed in order to verify if there were dermoscopic features able to discriminate between SN and AST. No significant dermoscopic criteria were found to distinguish AST from SN. This support the hypothesis that AST was should be considered not as a different entity but within the spectrum of AN lesions.