Spitz naevi and melanomas with similar dermoscopic patterns: can confocal microscopy differentiate? | British Journal of Dermatology

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Previous studies have reported the pote","pageStart":"610","pageEnd":"616","siteName":"OUP Academic","thumbnailURL":"https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/bjd/174/3/10.1111_bjd.14286/1/m_bjd14286-fig-0001.jpeg?Expires=1794693022&Signature=cSk1GDrYgHthmA3C-gp5l6DSnfAAapk7FJlTnyZJDsvoHZr-87Rbq43cZKP1fLq1RvlF1P30Q19Ri89MWZFr9-2AJ~NdWCMLgUeYIvUK9cieTQ3FWpvXmTHMReJPLDGw2jurY6RGJL4Vq78CpWLETiCP~J5DaT3TC6PThGocNl~IuqyxPUFYoRoa48RE0Cf~0qL09j7wasx9DZItm77H2XV2X9uwX36cJkAK2G3yCYUB~6GQmZABTU-IO0BGjvvNqPo68hVNDyURGnHgEvOdvx04t707x8LapgRMOyoOTUk4jc2G-BAG420Ee-N4mAHGCtl5KBqYKba7vKK8dB997g__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA","headline":"Spitz naevi and melanomas with similar dermoscopic patterns: can confocal microscopy differentiate?","image":"https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/bjd/174/3/10.1111_bjd.14286/1/m_bjd14286-fig-0001.jpeg?Expires=1794693022&Signature=cSk1GDrYgHthmA3C-gp5l6DSnfAAapk7FJlTnyZJDsvoHZr-87Rbq43cZKP1fLq1RvlF1P30Q19Ri89MWZFr9-2AJ~NdWCMLgUeYIvUK9cieTQ3FWpvXmTHMReJPLDGw2jurY6RGJL4Vq78CpWLETiCP~J5DaT3TC6PThGocNl~IuqyxPUFYoRoa48RE0Cf~0qL09j7wasx9DZItm77H2XV2X9uwX36cJkAK2G3yCYUB~6GQmZABTU-IO0BGjvvNqPo68hVNDyURGnHgEvOdvx04t707x8LapgRMOyoOTUk4jc2G-BAG420Ee-N4mAHGCtl5KBqYKba7vKK8dB997g__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA","image:alt":"(a) Dermoscopy of a starburst melanoma, 0·63 mm Breslow thickness. 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Differentiating Spitz naevi from melanomas can be difficult both clinically and dermoscopically. 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Bonamonte </div> </div> <div class="info-card-affilitation"> <div class="aff"><div class="institution">Dermatology Unit University of Bari ‘Aldo Moro’ Bari Italy</div></div> </div> <div class="info-card-search-label"> Search for other works by this author on: </div> <div class="info-card-search info-card-search-internal"> <a href="/bjd/search-results?f_Authors=D.+Bonamonte" rel="nofollow">Oxford Academic</a> </div> <div class="info-card-search info-card-search-google"> <a href="http://scholar.google.com/scholar?q=author:%22Bonamonte D.%22">Google Scholar</a> </div> </div> </span> </span> <span class="al-author-name-more js-flyout-wrap"> <button type="button" class="linked-name js-linked-name-trigger btn-as-link">C. Longo</button><span class='delimiter'></span> <span class="al-author-info-wrap arrow-up"> <div class="info-card-author authorInfo_OUP_Abstract_ArticleTop_Info_Widget"> <div class="name-role-wrap"> <div class="info-card-name"> C. Longo <span class="info-card-footnote"><span class="xrefLink" id="jumplink-cor1"></span><a href="javascript:;" reveal-id="cor1" data-open="cor1" class="link link-ref link-reveal xref-default"></a></span> </div> </div> <div class="info-card-affilitation"> <div class="aff"><div class="institution">Skin Cancer Unit Arcispedale S. Maria Nuova‐IRCCS Viale Risorgimento 80 42100 Reggio Emilia Italy</div></div> </div> <div class="info-author-correspondence"> <div content-id="cor1">Correspondence Caterina Longo. E‐mail: <a href="mailto:longo.caterina@gmail.com" target="_blank">longo.caterina@gmail.com</a></div> </div> <div class="info-card-search-label"> Search for other works by this author on: </div> <div class="info-card-search info-card-search-internal"> <a href="/bjd/search-results?f_Authors=C.+Longo" rel="nofollow">Oxford Academic</a> </div> <div class="info-card-search info-card-search-google"> <a href="http://scholar.google.com/scholar?q=author:%22Longo C.%22">Google Scholar</a> </div> </div> </span> </span> </div> </div> <div class="pub-history-wrap clearfix js-history-dropdown-wrap"> <div class="pub-history-row clearfix"> <div class="ww-citation-primary"><em>British Journal of Dermatology</em>, Volume 174, Issue 3, 1 March 2016, Pages 610–616, <a href='https://doi.org/10.1111/bjd.14286'>https://doi.org/10.1111/bjd.14286</a></div> </div> <div class="pub-history-row clearfix"> <div class="ww-citation-date-wrap"> <div class="citation-label">Published:</div> <div class="citation-date">01 March 2016</div> </div> </div> </div> </div> </div> <script> $(document).ready(function () { $('.article-top-widget').on('click', '.ati-toggle-trigger', function () { $(this).find('.icon-general-add, .icon-minus').toggleClass('icon-minus icon-general-add'); $(this).siblings('.ati-toggle-content').toggleClass('hide'); }); // In Chrome, an anchor tag with target="_blank" and a "mailto:" href opens a new tab/window as well as the email client // I suspect this behavior will be corrected in the future // Remove the target="_blank" $('ul.wi-affiliationList').find('a[href^="mailto:"]').each(function () { $(this).removeAttr('target'); }); }); </script> </div> <div class="widget widget-ArticleLinks widget-instance-OUP_Article_Links_Widget"> </div> <div class="article-body js-content-body"> <div class="toolbar-wrap js-toolbar-wrap"> <div class="toolbar-inner-wrap"> <ul id="Toolbar" role="navigation"> <li class="toolbar-item item-with-dropdown item-views"> <a class="at-views-dropdown drop-trigger" href="javascript:;" data-dropdown="FilterDrop" aria-haspopup="true"> <i class="icon-menu_views"></i> <div class="toolbar-label"> <div class="toolbar-text">Views</div> <i class="icon-general-arrow-filled-down arrow-icon"></i> </div> </a> <ul id="ViewsDrop" class="f-dropdown js-dropdown-content" data-dropdown-content aria-label="submenu"> <div class="arrow-up"></div> <li class="article-content-filter js-article-content-filter" data-content-filter="article-content"> <a href="javascript:;"><span>Article contents</span></a> </li> <li class="at-figures-tables article-content-filter js-article-content-filter" data-content-filter="figures-tables"> <a href="javascript:;"><span>Figures & tables</span></a> </li> <li class="article-content-filter js-article-content-filter" data-content-filter="video"> <a href="javascript:;"><span>Video</span></a> </li> <li class="article-content-filter js-article-content-filter" data-content-filter="audio"> <a href="javascript:;"><span>Audio</span></a> </li> <li class="article-content-filter js-article-content-filter" data-content-filter="supplementary-data"> <a href="javascript:;"><span>Supplementary Data</span></a> </li> </ul> </li> <li class="toolbar-item item-cite js-item-cite"> <div class="widget widget-ToolboxGetCitation widget-instance-OUP_Get_Citation"> <a href="#" class="js-cite-button at-CiteButton" data-reveal-id="getCitation" data-reveal> <i class="icon-read-more"></i> <span>Cite</span> </a> <div id="getCitation" class="reveal-modal js-citation-modal" data-reveal> <h3 class="modal-title">Cite</h3> <div class="oxford-citation-text"> <p>S. 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<div class="navbar-search-advanced"><a href="/bjd/advanced-search" class="advanced-search js-advanced-search">Advanced Search</a></div> </div> <div class="navbar-search-collapsed"><a href="javascript:;" class="icon-menu_search js_expand-navsearch"><span class="screenreader-text">Search Menu</span></a></div> </div> </div> <input id="routename" name="RouteName" type="hidden" value="bjd" /> </div> </div> </div> </div> <div id="ContentTab" class="content active"> <div class="widget widget-ArticleFulltext widget-instance-OUP_Abstract_Article_FullText_Widget"> <div class="module-widget"> <div class="widget-items" data-widgetname="ArticleFulltext"> <h2 scrollto-destination=400288832 id="400288832" class="abstract-title js-splitscreen-abstract-title" >Summary</h2> <section class="abstract"><div class=" sec"><div class="title">Background</div><p class="chapter-para">Differentiating Spitz naevi from melanomas can be difficult both clinically and dermoscopically. Previous studies have reported the potential role of <em>in vivo</em> reflectance confocal microscopy (RCM) in increasing diagnostic accuracy.</p></div><div class=" sec"><div class="title">Objectives</div><p class="chapter-para">To define RCM criteria that can differentiate ‘false twins’, namely Spitz naevi and melanomas sharing similar dermoscopic appearance.</p></div><div class=" sec"><div class="title">Methods</div><p class="chapter-para">Lesions histopathologically diagnosed as Spitz naevi or melanomas were retrospectively retrieved. They were selected to cover all dermoscopic types and were put into couples sharing similar aspects. Lesions were classified into three main dermoscopic categories: globular and starburst pattern, spitzoid with dotted vessels, and multicomponent or aspecific pattern.</p></div><div class=" sec"><div class="title">Results</div><p class="chapter-para">RCM findings revealed that striking cell pleomorphism within the epidermis, widespread atypical cells at the dermoepidermal junction and marked pleomorphism within nests were significantly associated with the diagnosis of melanoma, while spindled cells and peripheral clefting were found exclusively with and pathognomonic of Spitz naevi. Furthermore, the analysis of a dermoscopic subgroup highlights the importance of striking pleomorphism and spindled cells as clues to differentiate ‘false twins’ with globular or starburst patterns.</p></div><div class=" sec"><div class="title">Conclusions</div><p class="chapter-para">The current study highlights the role of RCM in discriminating ‘false twins’ of Spitz naevi and melanomas for lesions showing starburst and globular patterns on dermoscopy, whereas RCM is not useful in the other dermoscopic subgroups.</p></div></section> <div class="article-metadata-panel clearfix at-ArticleMetadata"></div>  <div class="widget widget-ArticlePubStateInfo widget-instance-OUP_ArticlePubStateInfo"> </div> <div class="article-metadata-standalone-panel clearfix"></div> <div class="copyright copyright-statement">© 2016 British Association of Dermatologists</div><div class="license"><div class="license-p">This article is published and distributed under the terms of the Oxford University Press, 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Spitz naevi and melanomas with similar dermoscopic patterns: can confocal microscopy differentiate? | British Journal of Dermatology | Oxford Academic