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Am J Dermatopathol 2021 May 11. Epub 2021 May 11.

Departments of Dermatology, and Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; and AU/UGA Medical Partnership, Medical College of Georgia, Athens, GA.

Abstract: In their 2018 article, Lezcano et al [AJSP 2018(11):1456] show that diffuse tumor cell nuclear reactivity for Preferentially expressed Antigen in Melanoma (PRAME) is a feature of melanoma and that benign and atypical melanocytic tumors are PRAME negative or show only focal positivity for PRAME. We report our observations of PRAME staining in 253 melanocytic tumors. Tumors were classified by hematoxylin and eosin sections. Read More

J Cutan Pathol 2021 May 12. Epub 2021 May 12.

Department of Biopathology, Center Léon Bérard, Lyon, France.

Fusions of ALK, ROS1, NTRK1, NTRK3, RET, MET, MERTK, FGFR1, ERBB4, LCK, BRAF, MAP3K8, MAP3K3, and PRKDC and mutation of HRAS have so far been discovered as the genetic alterations associated with the pathogenesis of Spitz neoplasms. This report presents the first case of NTRK2-rearranged Spitz/Reed nevus. The patient was a 39-year-old male with a pigmented macule rapidly growing on his shoulder. Read More

Ann Dermatol 2020 Jun 24;32(3):233-236. Epub 2020 Apr 24.

Department of Dermatology, Kosin University College of Medicine, Busan, Korea.

Spark's nevus is a compound word composed of Spitz nevus and Clark's nevus. It is one of the combined melanocytic nevi which is more common in female and usually presents as a sharp circumscribed hyperpigmented macule on the lower extremities. On histopathologic findings, both cytologic features of Spitz nevus characterized as large spindle or epithelioid melanocytes containing large nuclei with abundant cytoplasm, and architecture of Clark's nevus characterized as elongation of rete ridges, bridging of the nests, concentric and lamellar fibrosis can be seen. Read More

Acta Dermatovenerol Croat 2020 Dec;28(7):236-237

Prof. Luca Roncati, MD, DMLS, PhD , Polyclinic Hospital, Largo del Pozzo 71 - 41124 , Modena (MO), Italy;

Malignant melanoma (M) can be defined, quite simply, as a malignant neoplasm derived from melanocytes; however, there is great histological and, consequently, clinical variability from case to case (1). In order to try to overcome this intrinsic difficulty, various classification systems have been proposed over the years; as part of this effort, the World Health Organization (WHO) introduced its famous classification about half a century ago (2). Currently, the International Classification of Diseases for Oncology (ICD-O), provided by the WHO International Agency for Research on Cancer (IARC), distinguishes the in situ forms from invasive ones, recognizing four main morphological subtypes: nodular M, superficial spreading M, lentigo maligna M, and acral lentiginous M (3). Read More

Eur J Cancer 2021 May 25;148:340-347. Epub 2021 Mar 25.

Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany. Electronic address:

Accurate classification of melanocytic proliferations has important implications for prognostic prediction, treatment and follow-up. Although most melanocytic proliferations can be accurately classified using clinical and pathological criteria, classification (specifically distinction between nevus and melanoma) can be challenging in a subset of cases, including those with spitzoid morphology. Genetic studies have shown that mutation profiles differ between primary melanoma subtypes and Spitz nevi. Read More

Dermatol Pract Concept 2021 Mar 8;11(2):e2021024. Epub 2021 Mar 8.

Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Italy.

Virchows Arch 2021 Mar 17. Epub 2021 Mar 17.

Department of Biopathology, Center Léon Bérard, 28, rue Laennec, 69008, Lyon, France.

Spitz tumors are genetically associated with activating HRAS point mutations or fusions of either ALK, ROS1, NTRK1, NTRK3, RET, MET, MERTK, LCK, BRAF, MAP3K8, or MAP3K3. All these driver gene alterations are mutually exclusive. We report two cases of agminated Spitz naevi with a GOPC-ROS1 fusion. Read More

Cancers (Basel) 2021 Feb 16;13(4). Epub 2021 Feb 16.

Department of Thoracic Surgery, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239 Essen, Germany.

Spitzoid melanoma is a rare malignancy with histological characteristics similar to Spitz nevus. It has a diverse genetic background and in adults, a similarly grim clinical outcome as conventional malignant melanoma. We established a spitzoid melanoma cell line (PF130) from the pleural effusion sample of a 37-year-old male patient. Read More

Hum Pathol 2021 Feb 24;112:35-47. Epub 2021 Feb 24.

Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH, 03766, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA. Electronic address:

The most recent World Health Organization classification for skin tumors (2018) categorizes melanomas and their precursor lesions, benign or intermediate, into nine pathways based not only on their clinical and histomorphologic characteristics but also on their molecular profile and genetic fingerprint. In an index case of a partially sampled atypical spitzoid lesion, which proved to be an 11p-amplified Spitz nevus with HRASQ61R mutation, we observed cross-reactivity with the NRASQ61R antibody (clone SP174). Overall, we assessed the status of HRAS and NRAS genes and their immunoreaction to NRASQ61R antibody in 16 cases of 11p-amplified Spitz nevi/atypical Spitz tumors. Read More

Pediatr Dermatol 2021 Mar 2;38(2):461-463. Epub 2021 Feb 2.

Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy.

Agminated Spitz nevi are an uncommon entity, and their management is challenging due not only the young age of the patients but also the tumor's uncertain malignant potential and the variability in the dermoscopic and clinical presentation. We report a case of a 6-year-old boy with multiple agminated Spitz nevi on a café au lait macule with different atypical clinical patterns and dermoscopic features. Read More

Pigment Cell Melanoma Res 2021 Feb 1. Epub 2021 Feb 1.

Department of Dermatology, University of California in San Francisco, San Francisco, CA, USA.

Patients with non-supernumerary ring chromosome 7 syndrome have an increased incidence of hemangiomas, café-au-lait spots, and melanocytic nevi. The mechanism for the increased incidence of these benign neoplasms is unknown. We present the case of a 22-year-old man with ring chromosome 7 and multiple melanocytic nevi. Read More

Am J Dermatopathol 2021 May;43(5):377-380

Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.

Abstract: The synchronous incidence of 2 different subtypes of melanoma is very rare. Desmoplastic melanoma (DM) can be a diagnostic challenge because of its frequent appearance as a dermal banal spindle cell proliferation. We present a case of a 30-year-old man who developed an irregular, purple, tender plaque measuring 2. Read More

Virchows Arch 2021 Jan 12. Epub 2021 Jan 12.

Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy.

The recent WHO classification of skin tumors has underscored the importance of acknowledging intermediate grade melanocytic proliferations. A multistep acquisition of oncogenic events drives the progressive transformation of nevi into melanomas. The various pathways described are modulated by the initial oncogenic drivers that define the common, blue, and Spitz nevi groups. Read More

Am J Surg Pathol 2021 02;45(2):277-285

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.

A subset of Spitz tumors is associated with a copy number increase of chromosome 11p and activating mutations of HRAS. These aberrations have been reported to occur in association with desmoplastic Spitz nevi. Little is known to what extent 11p gains can also be found in nondesmoplastic tumors. Read More

Plast Reconstr Surg Glob Open 2020 Dec 18;8(12):e3244. Epub 2020 Dec 18.

Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, Mass.

Proper management of Spitz nevi continues to be debated, with treatment ranging from observation to surgery. To better characterize the outcome of surgical procedures performed for incomplete initial excision or biopsy, we sought to ascertain the histopathological presence of residual Spitz nevi in a set of surgical specimens.

Methods: We retrospectively reviewed 123 records with histologically-confirmed Spitz nevus. Read More

Dermatol Pract Concept 2021 Jan 10;11(1):e2020101. Epub 2020 Dec 10.

Department of Dermatology, Henry Ford Health System, Detroit, MI, USA.

Am J Dermatopathol 2020 Dec;42(12):923-931

Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL.

With the advent of better molecular characterization of Spitz melanocytic neoplasms, there has been increasing effort to better understand and describe the relationships between specific driver fusion and/or mutations with the clinical and histomorphological characteristics of the lesions. Structural rearrangements in mitogen activated protein kinase genes have recently been noted to be important in Spitz neoplasms. Only very few reports, however, have described in detail melanocytic tumors with in frame deletions in MAP2K1. Read More

Pediatr Dermatol 2020 Nov;37(6):1083-1084

Harvard Medical School, Boston, MA, USA.

Am J Dermatopathol 2020 Dec 1. Epub 2020 Dec 1.

Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic.

Specific alterations involving MAPK genes (MAP3K8 fusions, MAP3K3 fusions) have been recently detected in a subgroup of spitzoid neoplasms that seem to constitute a distinctive clinicopathologic group, occur mostly in younger patients (median age 18 years) and present with atypical histologic features associated with frequent homozygous deletion of CDKN2A, qualifying a high proportion of them as Spitz melanoma (malignant Spitz tumor). Apart from lesions with spitzoid morphology harboring MAP3K8 or MAP3K3 fusion, a single case with MAP2K1 deletion has been identified. The authors report herein 4 melanocytic lesions with a MAP2K1 mutation, all showing similar microscopic appearances, including spitzoid cytology and dysplastic architectural features, resembling so-called SPARK nevus, suggesting that these lesions may represent another distinctive group. Read More

Diagn Pathol 2020 Oct 25;15(1):132. Epub 2020 Oct 25.

Third Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.

Background: Spitzoid melanocytic lesions represent a heterogeneous group of proliferations with ambiguous and overlapping terminology. The exact distinction of a Spitz nevus from a Spitzoid melanoma can be very difficult or, in some cases, impossible. Among the Spitzoid lesions, there is a lesion termed an atypical Spitz tumour (AST) that has intermediate histopathologic features between those of a Spitz nevus and a Spitzoid melanoma and thus uncertain malignant potential. Read More

J Cutan Pathol 2021 Apr 12;48(4):511-518. Epub 2020 Nov 12.

Department of Dermatology, University Hospitals of Cleveland, Cleveland, Ohio, USA.

Background: Spitz nevi are benign melanocytic neoplasms that typically present as rapidly growing solitary lesions on the head, neck, or lower extremities. Very rare reports have been described in African Americans.

Methods: A single-institution 29-year retrospective review of African American patients diagnosed with Spitz nevi was thoroughly analyzed in order to characterize these rare clinical and histopathologic presentations. Read More

Actas Dermosifiliogr 2021 Mar 11;112(3):266-267. Epub 2020 Oct 11.

Servicio de Dermatología, Hospital Clínico Universitario de Salamanca, Salamanca, España.

Virchows Arch 2020 Oct 11. Epub 2020 Oct 11.

Department of Pathology, Division of Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.

The molecular background of a significant proportion of spitzoid neoplasms is still unknown. Recently, activating mutations in MAP2K1 have been described in a few spitzoid lesions, but not in benign Spitz nevi. We report four cases of melanocytic tumors with spitzoid features in which a MAP2K1 mutation was detected. Read More

J Cutan Pathol 2021 Jan 8;48(1):154-159. Epub 2020 Nov 8.

Department of Pathology, Stanford Medicine, Stanford, California, USA.

Historically recognized by their characteristic histopathologic features, Spitz neoplasms are now known to be molecularly defined by mutually exclusive recurrent abnormalities that cause activation of the MAPK pathway. Spitz neoplasms with ALK rearrangements frequently demonstrate polypoid growth with a plexiform arrangement of nested, fusiform melanocytes in intersecting fascicles. Although neurotropism has been described in indolent Spitz neoplasms, this feature is not frequently mentioned in publications on histopathologic assessment of this group of melanocytic tumors. Read More

Ocul Oncol Pathol 2020 Aug 28;6(4):293-296. Epub 2020 Jan 28.

Section of Ophthalmic Pathology, Department of Pathology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.

We describe the first presentation of a deep penetrating nevus (DPN) on the lacrimal caruncle. This lesion was seen in an 18-year-old woman presenting with hemorrhage of a long-standing pigmented mass on the caruncle. Histology showed a combined melanocytic neoplasm that consisted of two different melanocytic components. Read More

Sci Rep 2020 10 1;10(1):16216. Epub 2020 Oct 1.

Department of Dermatology, University of California San Francisco, 1701 Divisadero St. Ste. 280, San Francisco, CA, 94143, USA.

Metastasis is generally considered a characteristic of malignant tumors. Herein, we describe a patient with more than one hundred discrete Spitz nevi scattered all over her skin. Molecular analysis from three of the lesions identified a ROS1 fusion oncogene with identical genomic breakpoints, indicating that the nevi arose from a single transformed melanocyte and then disseminated throughout the integument. Read More

Histopathology 2021 Mar 19;78(4):607-626. Epub 2020 Nov 19.

Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands.

Aims: The role of inflammation in conventional cutaneous melanoma has been extensively studied, whereas only little is known about the inflammatory microenvironment and immunogenic properties of spitzoid melanocytic neoplasms. The composition of infiltrating immune cells and the architectural distribution of the inflammation, in particular, are still obscure. This is the first study, to our knowledge, to systematically characterise the inflammatory patterns and the leucocyte subsets in spitzoid melanocytic lesions. Read More

Dermatol Ther (Heidelb) 2020 Dec 18;10(6):1405-1413. Epub 2020 Sep 18.

Department of Dermatology, University Hospital Centre, CHU du Sart-Tilman, Liege, Belgium.

Introduction: Teledermoscopy using smartphone-based applications is becoming more and more important in a setting of increasing frequency of skin cancer and difficult access to specialized care. The TELESPOT project aimed to provide rapid diagnosis and speed up patient flow between primary healthcare centers and a tertiary care center in Belgium. The aim of the present study is to describe the development of an in-house smartphone-based dermoscopy application, evaluate its real-life value in a series of primary healthcare centers, and present preliminary diagnostic data. Read More

Ital J Dermatol Venerol 2021 Feb 17;156(1):111-112. Epub 2020 Sep 17.

Section of Dermatology, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy.

Mod Pathol 2021 02 29;34(2):348-357. Epub 2020 Aug 29.

Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

The presence of a characteristic chimeric fusion as the initiating genomic event is one defining feature of Spitz neoplasms. Characterization of specific subtypes of Spitz neoplasms allows for better recognition facilitating diagnosis. Data on clinical outcomes of the specific tumor types may help in predicting behavior. Read More