• How do you differentiate between an atypical spitz nevus and melanoma?

    Asked by Sunnysideup on Wednesday, March 6, 2013

    How do you differentiate between an atypical spitz nevus and melanoma?

    1 Answer from the Community

    • carm's Avatar

      First let me say that you ask a great question, and one that has really been debated by many. An atypical spitzoid tumor or STUMP (spitzoid tumor of uncertain malignant potential) is very difficult to distinguish from a malanoma, and because of this it is a rule of thumb to excise or remove it. However, the differences boil down to genetics in the DNA of the cell. This mutation is on the long arm (q) of chromosome #1. S100 are proteins, calcium binding proteins on the cells and there are many subtypes. Histologically or through tissue biopsy, the subtype S100A6 is much more stongly expressed in a Spitz Nevi than in melanoma, and it is considered as a great marker to try and distinguish between the two. However, to distinguish in any other way other than at a molecular level, is really very hard to do as visually, they are too similar. I wish that I could tell you there is a much easier way, but sadly there is not. It is often best to remove them because of their potential and because the similarities are too close. Best of luck to you, Carm RN.

      over 4 years ago

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