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Background: Halo nevi are defined as benign melanocytic nevi that are surrounded by a rim of depigmentation, resembling a halo. This phenomenon often indicates the beginning of involution and subsequent regression of the melanocytic nevus, a process that extends over a period of several months. The consensus is that the central lesion should be evaluated and biopsied if there is clinical suspicion of dysplasia or malignancy. Objectives: To determine the characteristics of halo nevi excised in southern Israel during a decade. Methods: The Soroka University Medical Center is the regional hospital of southern Israel with its pathology institute evaluating all of the cutaneous lesions excised in the Soroka University Medical Center and most of the outpatient clinics in the region. We conducted a retrospective study compiling demographic and histopathological data from the institute's computerized system on all patients that underwent an excision of a cutaneous lesion that later was diagnosed histopatholgically as a halo nevus between the years 1996 and 2005. Results: Thirty six lesions were diagnosed as halo nevi, with characteristics similar to previous publications. Two of the 36 lesions were not clinically suspicious for dysplasia but were histologically diagnosed as dysplastic nevi. Conclusions: The clinician should evaluate the central lesion as suggested in previous publications, albeit with a higher level of suspicion for dysplasia, since the halo phenomenon and the regression of the pigmented nevus may interfere with accurate clinical diagnosis. Keywords: halo nevus | excision | dysplasia | Israel, Introduction Halo Nevi (HN), also termed Sutton nevi, leukoderma acquisitum centrifugum, or halo phenomenon, are defined as benign melanocytic nevi that are surrounded by a rim of depigmentation, resembling a [...]

Background. Spitz Nevus still represents a challenge for dermato-pathologists in distinguishing it from malignant melanoma, particularly in adults. Spitz Nevus misdiagnosis may lead to serious consequences including malpractice claims. Objectives. The goal of the study is review of clinico-pathological characteristics of Spitz Nevi. Methods. In present study we reviewed a series of 79 consecutive patients with histologically proved Spitz Nevi between the years 1996-2004. The histological reports were evaluated for parameters associated with the lesion's diameter, location, subtype, operating setting (community clinics vs. hospital) and correlation with possible future appearance of malignant melanocytic lesion's. Results. Spitz nevus prevalence among removed nevi in 8-year period is 0.6%. In our series 68.4% of patients were younger than 20 years old, equally distributed according to gender. Spitz nevi were predominantly excised in compound phase in respect to their subtype. Conclusions. We did not revealed any unique clinical features distinguishing Spitz nevus from other melanocytic nevi. Keywords: Spitz nevus | melanocytic nevus | malignant melanoma, Introduction Since the first description of spindle cell nevus by Sophie Spitz in 1948, numerous papers have been published on this controversial lesion. Spitz nevus (SN) still represents a challenge [...]

Background. The incidence of cutaneous malignant melanoma (CMM) is rising worldwide and so is its morbidity and mortality. We define the term incidental malignant melanoma (IMM) to describe a lesion referred to surgical treatment with clinical diagnosis other than melanoma or dysplastic nevus. Objectives. The goal of this study is to assess incidence and characteristics of incidental melanomas, to explore the reasons for such a diagnosis failure and possible ways of preventing it. Methods. This is a retrospective study of 173 skin lesions diagnosed as CMM in 1996-2004. 28 lesions were IMM (16.2%). Results. IMMs were strongly associated with high Breslow and Clark level and community clinic versus hospital setting as the primary diagnosing site. Conclusions. We found a high percent of IMM in our patient population. This group of high-risk patients is prone to delayed definitive treatment and possible worse prognosis. In view of acute increase in CMM incidence a higher suspicion attitude of not only pigmented skin lesions should be implemented especially in community services. Keywords: misdiagnosed melanoma | incidental malignant melanoma | cutaneous MM | BCC | SCC, Introduction The incidence of cutaneous malignant melanoma (CMM) is rising worldwide and so is the morbidity and mortality. CMM constitutes approximately 11% of all skin cancers [1] but it is [...]