TY - JOUR
T1 - Update on dermoscopy of Spitz/Reed naevi and management guidelines by the International Dermoscopy Society
AU - the International Dermoscopy Society
AU - Lallas, A.
AU - Apalla, Z.
AU - Ioannides, D.
AU - Lazaridou, E.
AU - Kyrgidis, A.
AU - Broganelli, P.
AU - Alfano, R.
AU - Zalaudek, I.
AU - Argenziano, G.
AU - Bakos, Renato
AU - Blum, Andreas
AU - Braun, Ralph
AU - Cabo, Horacio
AU - Halpern, Allan
AU - Hofmann-Wellenhof, Rainer
AU - Kittler, Harald
AU - Malvehy, Josep
AU - Marghoob, Ashfaq
AU - Menzies, Scott
AU - Moscarella, Elvira
AU - Paoli, John
AU - Pellacani, Giovanni
AU - Puig, Susana
AU - Rabinovitz, Harold
AU - Scope, Alon
AU - Soyer, Peter
AU - Stolz, Wilhelm
AU - Tanaka, Masaru
AU - Thomas, Luc
AU - Tschandl, Philipp
N1 - Publisher Copyright:
© 2017 British Association of Dermatologists
PY - 2017/9
Y1 - 2017/9
N2 - Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical recognition, biological behaviour and management strategies. Although Spitz naevi are considered benign tumours, their clinical and dermoscopic morphological overlap with spitzoid melanoma renders the management of spitzoid lesions particularly difficult. The controversy deepens because of the existence of tumours that cannot be safely histopathologically diagnosed as naevi or melanomas (atypical Spitz tumours). The dual objective of the present study was to provide an updated classification on dermoscopy of Spitz naevi, and management recommendations of spitzoid-looking lesions based on a consensus among experts in the field. After a detailed search of the literature for eligible studies, a data synthesis was performed from 15 studies on dermoscopy of Spitz naevi. Dermoscopically, Spitz naevi are typified by three main patterns: starburst pattern (51%), a pattern of regularly distributed dotted vessels (19%) and globular pattern with reticular depigmentation (17%). A consensus-based algorithm for the management of spitzoid lesions is proposed. According to it, dermoscopically asymmetric lesions with spitzoid features (both flat/raised and nodular) should be excised to rule out melanoma. Dermoscopically symmetric spitzoid nodules should also be excised or closely monitored, irrespective of age, to rule out atypical Spitz tumours. Dermoscopically symmetric, flat spitzoid lesions should be managed according to the age of the patient. Finally, the histopathological diagnosis of atypical Spitz tumour should warrant wide excision but not a sentinel lymph-node biopsy.
AB - Spitzoid lesions represent a challenging and controversial group of tumours, in terms of clinical recognition, biological behaviour and management strategies. Although Spitz naevi are considered benign tumours, their clinical and dermoscopic morphological overlap with spitzoid melanoma renders the management of spitzoid lesions particularly difficult. The controversy deepens because of the existence of tumours that cannot be safely histopathologically diagnosed as naevi or melanomas (atypical Spitz tumours). The dual objective of the present study was to provide an updated classification on dermoscopy of Spitz naevi, and management recommendations of spitzoid-looking lesions based on a consensus among experts in the field. After a detailed search of the literature for eligible studies, a data synthesis was performed from 15 studies on dermoscopy of Spitz naevi. Dermoscopically, Spitz naevi are typified by three main patterns: starburst pattern (51%), a pattern of regularly distributed dotted vessels (19%) and globular pattern with reticular depigmentation (17%). A consensus-based algorithm for the management of spitzoid lesions is proposed. According to it, dermoscopically asymmetric lesions with spitzoid features (both flat/raised and nodular) should be excised to rule out melanoma. Dermoscopically symmetric spitzoid nodules should also be excised or closely monitored, irrespective of age, to rule out atypical Spitz tumours. Dermoscopically symmetric, flat spitzoid lesions should be managed according to the age of the patient. Finally, the histopathological diagnosis of atypical Spitz tumour should warrant wide excision but not a sentinel lymph-node biopsy.
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U2 - 10.1111/bjd.15339
DO - 10.1111/bjd.15339
M3 - Review article
C2 - 28118479
AN - SCOPUS:85029693668
SN - 0007-0963
VL - 177
SP - 645
EP - 655
JO - British Journal of Dermatology
JF - British Journal of Dermatology
IS - 3
ER -