Caso di dermatoscopia
Exclusion from an amelanotic melanoma - Spitz nevus
In a 62-year-old female patient a symmetric reddish and elevated skin tumour was found at her right buttock (5x5 mm). This tumour appeared to grow in the last three months. She had skin type II, more than 20 small, non suspicious nevi in clinic and dermoscopy. No history of a melanoma in her own history or her family.
In dermoscopy a symmetric reddish tumour with clear asymmetric polymorphia of vessels as differential structures was visible: pin point vessels, comma vessels, hairpin-like vessels. In the tumour no pigment, network, globules or black dots were visible.
Diagnosis based histopathology
Atypical Spitz nevus
Remarks
In every solitary reddish skin tumour the differential diagnosis of an amelanotic melanoma should always be considered, particularly in tumour with a polymorphia of vessels.
In this case a re-excision with a safety-margin of 5mm at least was performed. In my opinion the diagnosis of an atypical Spitz nevus at the age of 62 years should be evaluated critically.
References
Argenziano G, Zalaudek I, Corona R et al. (2004) Vascular structures in skin tumors: a dermoscopy study. Arch Dermatol 140: 1485-1489
Blum A (2005) Rötlicher umschriebener Tumor am Fuß. Hautarzt 56: 170-172
Prof. Dr. A. Blum
Seestrasse 3a
78464 Konstanz
Germania