Topical mitomycin C in the treatment of pigmented conjunctival lesions.
OBJECTIVE
To assess the clinical efficacy of topical mitomycin C (MMC) 0.04% for the treatment of patients with pigmented conjunctival lesions. Clinical efficacy was evaluated on the basis of reduction in lesion size and degree of pigmentation and histologic study.


METHODS
Two patients, one with primary acquired conjunctival melanosis with atypia and another with conjunctival melanoma, were treated with topical MMC 0.04%. Before treatment, a biopsy was performed that confirmed the diagnosis and the absence of atypical melanocytes beyond the basal layer. In both patients, MMC was administered with sponges, while one patient additionally received MMC 0.04% drops. Each treatment cycle lasted 14 days, with repetition after 3 months when necessary. Follow-up was weekly, then monthly, and then every 6 months up to 3 years.


RESULTS
Treatment with topical MMC 0.04% not only reduced the size and degree of pigmentation clinical lesions in both patients but also eradicated atypical conjunctival melanocytes as observed in histologic studies. In the patient with primary acquired conjunctival melanosis, adjunct cryotherapy was required, along with various cycles of MMC, to reduce the pigmented areas of skin of the internal canthus and caruncle. In the second case, only MMC was used. No severe adverse reactions to the treatment were observed. After 3 years of follow-up, no clinical relapse has been detected.


CONCLUSIONS
Topical MMC 0.04% is an option worth considering for the treatment of pigmented conjunctival lesions, particularly as an adjunct to other forms of treatment.
Rodríguez-Ares
Teresa
T
Anterior Segment Unit, Department of Ophthalmology, Hospital de Conxo-Complejo Hospitalario, Universitario de Santiago de Compostela, C/Ramon Baltar, s/n 15706, Santiago de Compostela, La Coruna, Spain. trares@usc.es
Touriño
Rosario
R
De Rojas
Victoria
V
Becerra
Eugenio
E
Capeans
Carmen
C
D000287:Administration, Topical; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003229:Conjunctival Diseases / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008544:Melanocytes / Q000187:drug effects / Q000473:pathology; D008548:Melanosis / Q000188:drug therapy* / Q000473:pathology; D016685:Mitomycin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D009883:Ophthalmic Solutions; D016685:Mitomycin