Patients with Spitz nevi in the Greek population: Epidemiologic, Clinical, and histopathological characteristics

Abstract

Background

Spitz nevi may present with clinical and histopathological atypical features that do not affect patient prognosis, but may become worrisome for patients ≥40 years presenting with newly appearing SN.

Objective

Patient characteristics and sun behavior patterns were investigated in correlation with age. SN characteristics and histopathological attributes were also investigated in correlation with age.

Methods

Patients with histopathologicaly confirmed diagnosis of SN were invited for a clinical examination. Data such as skin type, number of banal/atypical nevi, sun exposure patterns, personal/family history etc., were collected. Histopathology preparations were re-examined by two different histopathologists and characteristics were collected based on a prespecified checklist. Patients were afterwards followed-up every 6 months.

Results

110 patients with SN were identified and assigned to 3 age groups. The most common area of presentation was the trunk, for the ≥40 years age group, and the limbs for the other age groups. Patients ≥40 years had a higher possibility of presenting with a nevus count ≥50 and at least one atypical nevus compared to the other age groups. Patients ≥40 years presented more commonly with a history of painful sunburn (100%) before the appearance of the SN, used less sunscreen, had higher sun exposure times and more clinical signs of solar skin damage compared to the other age groups. Finally, patients ≥40 years presented more commonly with signs of histopathological atypia such as presence of mitoses, cellular atypia and prominent nucleolus.

Conclusion

Patients ≥40 were more likely to report a history of longer sun exposure times, of never using a sunscreen and of having a history of painful sunburn. However, the importance of this observation remains to be elucidated since these patients also presented more commonly with lesions located on non-sun exposed areas (trunk), and higher nevus/atypical nevus counts.

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