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Melanoacanthoma simulating pigmented spitz nevus: an unusual dermoscopy pitfall
Luigi Rossiello1, Iris Zalaudek, Gerardo Ferrara
1Department of Dermatology, Second University of Naples, Naples, Italy.
Summary
The starburst pattern, a key sign of pigmented Spitz nevus, can also appear in melanoacanthoma. This case highlights the need for surgical excision and histopathologic evaluation of such lesions in adults.
Area of Science:
- Dermatology
- Dermoscopy
- Histopathology
Background:
- The starburst pattern is a characteristic dermoscopic feature of pigmented Spitz nevus.
- This pattern has also been infrequently reported in melanoma.
Observation:
- A 38-year-old Caucasian woman presented with a 4-mm pigmented skin lesion on her hip.
- Clinical, dermoscopic, and histopathologic examinations were conducted.
Findings:
- Dermoscopy revealed a starburst pattern with symmetrically distributed peripheral pigmented streaks.
- Preoperative diagnosis was pigmented Spitz nevus, leading to excision.
- Histopathologic examination confirmed the lesion to be a melanoacanthoma, not a Spitz nevus.
Implications:
- The starburst pattern, while typically indicative of pigmented Spitz nevus, can occur in other benign or malignant pigmented lesions.
- Adults with lesions showing a starburst pattern or spitzoid features require excision for definitive histopathologic diagnosis.