10.5826/dpc.1401a91
text/xml
2160-9381
3714
en
Sabina Vaccari
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
A Growing Conjunctival Pigmentation – Videodermoscopy of Conjunctival Melanoma
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2024-01-31
2023-07-23
2024-01-31
2024-02-21
e2024091
Dermatol Pract Concept
Sabina Vaccari
2024/01/31
10.5826/dpc.1401a91
e2024091
Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna; Department of Medical and Surgical Sciences, Alma Mater, University of Bologna, Italy
2160-9381
en
e2024091
Cinotti E, La Rocca A, Labeille B, et al. Dermoscopy for the Diagnosis of Conjunctival Lesions. Dermatol Clin. 2018;36(4):439-449. DOI: 10.1016/j.det.2018.05.011. PMID: 30201153.
A Growing Conjunctival Pigmentation – Videodermoscopy of Conjunctival Melanoma
https://dpcj.org/index.php/dpc/article/download/3714/2563
           A Growing Conjunctival Pigmentation –
         Videodermoscopy of Conjunctival Melanoma
            Lorenzo Maltoni1,2, Carlotta Baraldi1,2, Matilde Roda3, Arianna Grendele1,3,
                                  Emi Dika1,2, Sabina Vaccari1,2


1 Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
2 Department of Medical and Surgical Sciences, Alma Mater, University of Bologna, Bologna, Italy
3 Ophthalmolgy Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy



Citation: Maltoni L, Baraldi C, Roda M, Grendele A, Dika E, Vaccari S. A Growing Conjunctival Pigmentation – Videodermoscopy of
Conjunctival Melanoma. Dermatol Pract Concept. 2024;14(1):e2024091. DOI: https://doi.org/10.5826/dpc.1401a91
Accepted: August 31, 2023; Published: January 2024
Copyright: ©2024 Maltoni et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Lorenzo Maltoni, MD, Dermatology, Sant’Orsola-Malpighi Hospital, Via Massarenti 1, 40138 Bologna, Italy.
Phone: +39-0512144838 E-mail: lorenzo.maltoni2@studio.unibo.it




Case Presentation                                                        membrane flaps, followed by adjuvant therapy with cycles
                                                                         of topical mitomycin. Histological examination confirmed
A 60-year-old man was referred to our clinic with a history              the diagnosis of conjunctival melanoma infiltrating the sub-
of a progressively enlarging pigmented lesion on the con-                epithelial connective tissue with radial extension of intracon-
junctiva of the left eye for over 8 years. The pigmentation              junctival proliferation, 1.45 mm thick (pT1b). The patient
was unevenly distributed and affected both the paralimbal                visual function was fully preserved.
and the temporal bulbar conjunctiva (Figure 1A). The lesion
was completely asymptomatic, and it did not impact the vi-
                                                                         Teaching Point
sual capacity. The patient had no significant past medical
history and denied any localized trauma or infection. We                 Conjunctival melanoma is a rare but extremely life-
decided to perform a videodermoscopy of the lesion which                 threatening malignancy neoplasm with associated mor-
findings reveals a predominantly dark brown structureless                tality of up to 30% [1]. Mandatory is the recognition and
pattern with a touch of grayish-white veil, peripheral spots,            ­evaluation of pigmented conjunctival lesions, especially in
and intralesional vessels exhibiting heteromorphic features              patients with a history of progressive growth. Videodermos-
(Figure 1, B and C).                                                     copy can aid in identifying characteristic features such as
    The lesion was successfully excised by removal of the                a predominantly structureless pattern, grey-white veil, and
affected conjunctiva and reconstruction using amniotic                   polymorphic v­ essels [2].




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                                                                      References
                                                                      1. SKaštelan S, Gverović Antunica A, Beketić Orešković L, Salopek
                                                                         Rabatić J, Kasun B, Bakija I. Conjunctival Melanoma - Epide-
                                                                         miological Trends and Features. Pathol Oncol Res. 2018;24(4):
                                                                         787-796. DOI: 10.1007/s12253-018-0419-3. PMID: 29802540.
                                                                      2. Cinotti E, La Rocca A, Labeille B, et al. Dermoscopy for the
                                                                         Diagnosis of Conjunctival Lesions. Dermatol Clin. 2018;36(4):
                                                                         439-449. DOI: 10.1016/j.det.2018.05.011. PMID: 30201153.




Figure 1. (A) Black-brown pigmentation with uneven distribu-
tion involving paralimbal and the temporal bulbar conjunctiva of
the left eye. (B,C) Videodermoscopy findings. Predominantly dark
brown structureless pattern with a touch of grayish-white veil,
peripheral speckling, afferent and intralesional vessels exhibiting
­heteromorphic features. (B) 20X; (C) 40X.




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