Benign Conjunctival Melanocytic Lesions

Malignant Melanoma of the Conjunctiva

“…8 The predominant benign conjunctival melanocytic lesions are composed of a variety of nevi and melanoses that also have a predilection for the perilimbal bulbar conjunctiva. 9,10 Nevi are believed to be congenital lesions that are generally unilateral. They are usually first identified clinically around puberty or early adulthood, with a range from early childhood to the 10th decade of life.…”

“…They are usually first identified clinically around puberty or early adulthood, with a range from early childhood to the 10th decade of life. 9,10 They frequently develop cysts and become slightly elevated, and may change in color and size. 9,10 Dark brown melanotic pigmentation is normally observed in the conjunctiva, a condition referred to as racial melanosis, which is especially evident bilaterally from an early age in more heavily pigmented races.…”

“…9,10 They frequently develop cysts and become slightly elevated, and may change in color and size. 9,10 Dark brown melanotic pigmentation is normally observed in the conjunctiva, a condition referred to as racial melanosis, which is especially evident bilaterally from an early age in more heavily pigmented races. This condition is usually in the form of an excess production of melanin or hyperpigmentation by the melanocytes (forming an ephelis) or benign proliferation of melanocytes (forming a benign lentigo).…”

Pigmented spindle cell naevus of Reed presenting in the conjunctiva

“…Clinically, most skin PSCN are dark brown to black, 3 to 6 mm in diameter, and occur most commonly on the extremities and the back of women in the third decade of life (Sagebiel et al 1984;Sau et al 1993). In contrast, the Spitz naevus is usually non-pigmented presenting as a uniformly pink or flesh coloured papule in the skin (Elder & Murphy 1991) or conjunctiva (Boccard et al 1988;Folberg et al 1989: Wachtel et al 1967.…”

“…Uncommon variants recognized in the conjunctiva include the balloon cell naevus (Pecorella 1996 et al) and the naevus of Spitz (Boccard et al 1988;Folberg et al 1989;McDonnell et al 1989;Wachtel et al 1967). Another subtype is the pigmented spindle cell naevus (PSCN), first recognized in the skin by Reed et al (1975), but until now not reported to occur in the conjunctiva, though the possible existence of a limbal PSCN was postulated a decade ago (Folberg et al 1989). In the skin, both the Spitz naevus and the PSCN of Reed are known to be easily confused with melanoma on histopathological examination and the aim of this case report was to illustrate the features of a PSCN presenting in the conjunctiva.…”