Management of Pigmented Conjunctival Lesions

Abstract 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 ris...

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Bibliographic Details
Published in:The ocular surface 2012-10, Vol.10 (4), p.251-263
Main Authors: Oellers, Patrick, MD, Karp, Carol L., MD
Format: Article
Language:English
Subjects:
BRAF
complexion-associated melanosis
conjunctival melanosis
Conjunctival Neoplasms - diagnosis
Conjunctival Neoplasms - epidemiology
Conjunctival Neoplasms - therapy
genetics
Humans
Incidence
melanoma
Melanoma - diagnosis
Melanoma - epidemiology
Melanoma - therapy
Melanosis - diagnosis
Melanosis - epidemiology
Melanosis - therapy
nevus
Nevus, Pigmented - diagnosis
Nevus, Pigmented - epidemiology
Nevus, Pigmented - therapy
no-touch surgery
ocular surface
Ophthalmology
pigmented lesion
primary acquired melanosis (PAM)
Risk Factors
topical chemotherapy
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Summary:Abstract 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.
ISSN:1542-0124
1937-5913
DOI:10.1016/j.jtos.2012.08.002