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February 2011February 21, 2011

Differential Diagnosis of Melanocytic Lesions and Molecular Biology

Author Affiliations

Author Affiliations: Departments of Dermatology (Drs Dummer, Kerl, and Kamarachev) and Pathology (Dr Mihic), University Hospital of Zurich, Zurich, Switzerland.

Arch Dermatol. 2011;147(2):232-233. doi:10.1001/archdermatol.2010.438

In this issue of the Archives, Boone et al1 present 2 intriguing cases of multiple Spitz nevi. Disseminated multiple Spitz nevi are extremely rare, and their major differential diagnosis is melanoma metastases with unknown primary origin. The diagnosis is made on the basis of clinical features, dermoscopy, and histologic findings. Because the histologic evaluation of spitzoid melanocytic proliferations is a major challenge, recent developments in molecular biology, such as fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH), have become increasingly popular in these cases, with the aim of improving the diagnostic accuracy. Our current understanding, based on artificial disease categories, assumes that malignant (melanoma) cells display more genomic alterations than neoplastic cells of Spitz nevi and benign melanocytic lesions.2

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