Combination topical therapy for conjunctival primary acquired melanosis with atypia and periocular lentigo maligna.
OBJECTIVE
To report the case of a patient who initially presented with primary acquired melanosis (PAM) without atypia of the conjunctiva and later developed lentigo maligna of the eyelids and PAM with atypia of the conjunctiva. We illustrate the utility of combination topical therapy with adjunctive cryotherapy to treat extensive eyelid and conjunctival lesions.


METHODS
Case report with a review of the current literature.


RESULTS
Combination of imiquimod 5% cream (Aldara, 3M Pharmaceuticals) and cryotherapy for periorbital lentigo maligna with topical interferon-α2b for conjunctival PAM with atypia led to clinical resolution of pigmented lesions for 21 months.


CONCLUSIONS
In our experience, combination topical therapy provides an effective alternative to surgery with superior cosmetic and functional outcomes.
*Department of Ophthalmology, University of Colorado, Aurora, CO; †Department of Dermatology, University of Colorado, Aurora, CO; ‡Texas Oculoplastic Consultants, Austin, TX; §Department of Ophthalmology, Division of Corneal and External Disease, University of Colorado, Aurora, CO; and ¶Department of Moh's Micrographic Surgery, University of Colorado, Aurora, CO.
Emily M
EM
Bratton
Siri
S
Knutsen-Larson
Vikram D
VD
Durairaj
Darren G
DG
Gregory
J Ramsey
JR
Mellette
D000287:Administration, Topical; D000369:Aged, 80 and over; D000634:Aminoquinolines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003229:Conjunctival Diseases / Q000473:pathology / Q000628:therapy*; D017679:Cryotherapy / Q000379:methods*; D005142:Eyelid Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000473:pathology / Q000628:therapy*; D000077271:Imiquimod; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D008548:Melanosis / Q000473:pathology / Q000628:therapy*; D011994:Recombinant Proteins / Q000008:administration & dosage
D000634:Aminoquinolines; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D000077271:Imiquimod