Spitz nevus in a hispanic population: A clinicopathological study of 130 cases

Alma C. Berlingeri-Ramos, Adisbeth Morales-Burgos, Jorge L. Sánchez, Elena M. Nogales

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25 Scopus citations

Abstract

Spitz nevus is an uncommon melanocytic nevus distinctive by its epithelioid and spindled melanocytes. Many studies have attempted to characterize Spitz nevus, but none of them in a Hispanic population. Our aim is to characterize the clinical and histopathological presentation of the Spitz nevus in a Hispanic population. A retrospective study was carried out from our files that included those cases histopathologically diagnosed as Spitz nevus. A blinded examination was performed to evaluate the histopathological characteristics of 130 lesions. The demographics of the patients, the anatomic location, and the accuracy of the clinical diagnosis were analyzed. Eighty-one females and 49 males (ratio of 1.7:1) were included in the study. The mean age was 18.8 years. Overall, the most common location was the lower extremities (41%), followed by the upper extremities (27%), trunk (16%), and head and neck (16%). The nevi followed a similar anatomic distribution in females and males. The lesions were clinically diagnosed with accuracy in 20% of the cases and characterized as a pigmented papule in 42% of the cases. Upon histopathological evaluation, most nevi exhibited symmetry (84%), were well circumscribed (91%), and exhibited epidermal hyperplasia (69%). The junctional type was seen in 42% of the cases, the compound type in 38%, and the dermal type in 20%. Sixty-eight percent of nevi were mostly composed of epithelioid melanocytes, the spindled-shaped melanocytes predominated in 17% of cases, and 12% were composed of both epithelioid and spindled-shaped melanocytes. Multinucleated melanocytes were seen in 7% of nevi, mostly in the epithelioid Spitz nevus (67%). Abundant melanin was observed in 51 cases, from which the most common variant was the classic Spitz nevi. The typical dull eosinophilic globules (Kamino bodies) were observed in a minority of the cases (11%), mostly in the classic Spitz nevus. The most common variant was the classic Spitz nevus (65%), followed by the dermal Spitz nevus (15%). In conclusion, Spitz nevus in a Hispanic population most commonly presents as a pigmented papule on the lower extremities irrespective of sex and age. It is characterized by a melanocytic proliferation most commonly composed of nested epithelioid melanocytes in a junctional or compound arrangement, with the presence of abundant melanin.

Original languageEnglish (US)
Pages (from-to)267-275
Number of pages9
JournalAmerican Journal of Dermatopathology
Volume32
Issue number3
DOIs
StatePublished - May 1 2010

Keywords

  • Epithelioid and spindle cell nevus
  • Hispanic population
  • Histopathology
  • Spitz nevus

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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    Berlingeri-Ramos, A. C., Morales-Burgos, A., Sánchez, J. L., & Nogales, E. M. (2010). Spitz nevus in a hispanic population: A clinicopathological study of 130 cases. American Journal of Dermatopathology, 32(3), 267-275. https://doi.org/10.1097/DAD.0b013e3181c52b99