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Dramatic regression of conjunctival and corneal acquired melanosis with topical mitomycin C
  1. Carol L Shields,
  2. Hakan Demirci,
  3. Jerry A Shields,
  4. Christopher Spanich
  1. Ocular Oncology Service, Wills Eye Hospital Service, Thomas Jefferson University, Philadelphia, PA, USA
  1. Correspondence to: Carol L Shields, MD, Ocular Oncology Service, Wills Eye Hospital, 900 Walnut Street, Philadelphia, PA 19107, USA

https://doi.org/10.1136/bjo.86.2.244

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    Conjunctival primary acquired melanosis is the most important precursor of conjunctival malignant melanoma.1,2 Primary acquired melanosis appears as flat, patchy, non-cystic pigmentation in the conjunctival epithelium and can remain dormant for years or show slow progression.2 Studies have shown that it leads to conjunctival melanoma in approximately 1% to 30% patients.3,4 Treatment of primary acquired melanosis includes observation, excisional biopsy, alcohol epitheliectomy, cryotherapy, and topical chemotherapy.1,2,5,6 We illustrate a dramatic case where topical chemotherapy provided complete regression of advanced, aggressive primary acquired melanosis.

    A 73 year old white man had noted slowly progressive pigmentation on the surface of his right eye for 5 years. A biopsy revealed intraepithelial conjunctival melanosis with atypia. The patient was referred to the Oncology Service at Wills Eye Hospital for evaluation and management. On examination, his visual acuity was 20/20 right …

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