Female, 16 years. Skin papule, upper legShow diagnosis & comments
Spitzoid superficial spreading melanoma
At low power, this spitzoid lesion looks deceptively regular and therefore gives an impression of a benign lesion, but at medium and higher power, it can be recognized as a melanoma: closely apposed strands and small nodules of mitotically active atypical cells; compact architecture also at the base of the lesion; 'epidermal consumption'; disproportionally enlarged nucleoli.
Spitzoid melanomas are proportionally more common in adolescents than in adults, which compounds the problem of their recognition.