This study focusing on the clinical and dermoscopic features of Atypical Spitz Tumors (ASTs) as well as on their evolution over time revealed that ASTs neither recurred nor progressed as distant metastases when patients were followed up for a long period of time. This confirms a good clinical outcome, even in the case of sentinel lymph node positivity. Findings demonstrate a typical dermoscopic picture concerning amelanotic ASTs with a glomerular vascular pattern throughout the lesion in the absence of other dermoscopic parameters, making a correct diagnosis possible.

• In this descriptive, multicenter study, 99 patients with a histologically confirmed diagnosis of AST were analyzed: 62 females and 37 males, age at presentation ranged from 2 to 70 years (mean 28.1 years, median 24 years).

• Of participants, 29 had sentinel lymph node biopsy with evidence of micrometastases in 3 cases (10.3%), followed by complete lymph node dissection with no evidence of further metastasis.

• An excellent clinical outcome was reflected by the absence of recurrence or distant metastasis in all cases.

• For 26 lesions, clinical and dermoscopic features were obtained; of them, multicomponent pattern (34.6%) was most frequently noted, followed by homogeneous (26.9%) and non-specific (23.2%).

• Glomerular (coiled) vessels uniformly distributed within the entire lesion, without asymmetry, was noted in 66.7% of amelanotic ASTs.