Management of pigmented conjunctival lesions.
Pigmented conjunctival lesions primarily include melanoma, nevus, primary acquired melanosis (PAM), and complexion-associated melanosis. The incidence of conjunctival malignant melanoma (CMM) has significantly increased in the USA and Europe over the years, and it carries a very serious risk for metastasis and melanoma-related death. Conjunctival melanoma can arise de novo or from precursor lesions, nevus, and PAM. PAM is histologically separated into two distinct forms: PAM with atypia and without atypia. PAM with severe atypia progresses to malignant melanoma in up to 50% of cases and PAM without atypia virtually never progresses. Nevus is a benign melanocytic tumor that only rarely undergoes malignant transformation. Complexion-associated melanosis is frequently seen in more darkly pigmented individuals and does not progress to melanoma, although it can become very large. A detailed literature review on the various pigmented conjunctival lesions together with a schematic approach to diagnosis and management is presented.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Patrick
P
Oellers
Carol L
CL
Karp
D003230:Conjunctival Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008548:Melanosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors