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.

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Grading system for atypical Spitz tumors