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Grading system for atypical Spitz tumors

Grading system for atypical Spitz tumors
Parameter Score
Age (years)
0 to 10 0
11 to 17 1
Diameter, mm
0 to 10 0
>10 1
Subcutaneous involvement
Absent 0
Present 2
Ulceration
Absent 0
Present 2
Mitotic activity/mm2
0 to 5 0
6 to 8 2
>8 5
Total*  
* 0 to 2 indicates low risk; 3 to 4, intermediate risk; 5 to 11, high risk.
Reproduced with permission from: Spatz A, Calonje E, Handfield-Jones S, Barnhill RL. Spitz tumors in children: a grading system for risk stratification. Arch Dermatol 1999; 135:282. Copyright © 1999 American Medical Association. All rights reserved.
Graphic 85913 Version 16.0