PMID- 16651212
OWN - NLM
STAT- MEDLINE
DCOM- 20060613
LR  - 20060502
IS  - 1529-1839 (Print)
IS  - 1558-1527 (Linking)
VI  - 77
IP  - 5
DP  - 2006 May
TI  - Primary acquired melanosis of the conjunctiva.
PG  - 223-8
AB  - BACKGROUND: Primary acquired melanosis (PAM) presents as a unilateral patchy area 
      of conjunctival pigmentation mostly found in middle-aged or elderly white 
      patients. Because PAM has the potential of becoming malignant, it is important to 
      recognize PAM and to rule out other causes of pigmented lesions. The presence or 
      absence of atypia is helpful in determining the potential for malignancy, because 
      PAM without atypia is usually benign, whereas PAM with atypia may convert into a 
      conjunctival melanoma. If atypia is present, the presence or absence of 
      epithelioid cells and the pattern of intraepithelial growth are the main factors 
      in determining the likelihood of neoplastic transformation. However, atypia can 
      only be determined with histopathologic examination. Therefore, a biopsy is 
      usually recommended. CASE REPORT: A 72-year-old white man presented for his 
      annual examination with no visual complaints. His ocular history was remarkable 
      for early cataracts and for a choroidal nevus. Slit lamp examination found a 
      large dark area of elevated conjunctival pigmentation at the medial canthus that 
      extended onto the superior bulbar conjunctiva and superior palpebral conjunctiva 
      in the left eye. No conjunctival pigmentation had been noted previously. Results 
      of a biopsy indicated primary acquired melanosis with atypia. The lesion was 
      surgically excised, and the conjunctiva was reconstructed with an amniotic 
      membrane graft. The patient was subsequently treated with topical 5-fluorouracil 
      chemotherapy. There have been no signs of recurrence to date after his treatment. 
      CONCLUSION: Because of the potential for malignancy, biopsies of all cases of 
      primary acquired melanosis are indicated. If atypia is present, treatment options 
      include local excision, cryotherapy, and topical chemotherapy.
FAU - Lin, Sandra M
AU  - Lin SM
AD  - VA Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center and 
      Nursing Home, Sepulveda, California 91434, USA.
FAU - Ferrucci, Steven
AU  - Ferrucci S
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Optometry
JT  - Optometry (St. Louis, Mo.)
JID - 100912421
SB  - IM
MH  - Aged
MH  - Biopsy
MH  - Conjunctival Diseases/*pathology
MH  - Diagnosis, Differential
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Melanosis/*pathology
EDAT- 2006/05/03 09:00
MHDA- 2006/06/14 09:00
CRDT- 2006/05/03 09:00
PHST- 2006/05/03 09:00 [pubmed]
PHST- 2006/06/14 09:00 [medline]
PHST- 2006/05/03 09:00 [entrez]
AID - S1529-1839(06)00151-5 [pii]
AID - 10.1016/j.optm.2006.02.007 [doi]
PST - ppublish
SO  - Optometry. 2006 May;77(5):223-8. doi: 10.1016/j.optm.2006.02.007.