Pediatric spitzoid lesions of the ear: a single center experience and review of literature

Abstract

Background and objectives. Spitzoid lesions are challenging melanocytic lesions comprising benign, intermediate, and malignant lesions. In this study, we aimed to analyze the diagnostic accuracy of clinical and dermatoscopical evaluation of pediatric spitzoid ear lesions. Materials and Methods. We collected and analyzed, clinically, dermatoscopically and histologically, pediatric spitzoid ear lesions. Also, we conducted a systematic review of literature. Results. At the Pediatric Hospital Gaslini, excision and histopathological evaluation were performed on eight cases: 87.5% of lesions were consistent with Spitz nevus (SN), and 12.5% with atypical Spitz tumor AST. Notably, multiple (≥2) dermatoscopical irregularities were present in five of seven SN (71%), yet none were found in AST 0/1 (0%). (Fisher’s exact test p=0.375). From systematic research of the literature, 9 patients were included in this review. At histology, 88.9% were SN, and 11% AST. Of note, also in literature, multiple dermatoscopical irregularities, were present in most SN (75%, 6/8), not in the identified AST (0%, 0/1) (p=0.3333). Conclusions. We present a monocentric study on pediatric spitzoid ear lesions. Importantly, dermatoscopical irregularities were not significantly associated to AST, neither in our series, nor in the reviewed literature (respectively p=0.375 and p=0.3333) supporting the fact that relying only on the dermatoscopical aspect of spitzoid lesions is not accurate enough for the special site of the ear, where dermatoscopy could be actually misleading.