Differences
This shows you the differences between two versions of the page.
| Both sides previous revision Previous revision Next revision | Previous revision | ||
| conjunctival_pigmented_lesions [2026/02/25 19:34] – [Lesions arising from melanocytes] Scott Larson | conjunctival_pigmented_lesions [2026/02/25 19:50] (current) – Scott Larson | ||
|---|---|---|---|
| Line 1: | Line 1: | ||
| ====== Conjunctival Pigmented Lesions ====== | ====== Conjunctival Pigmented Lesions ====== | ||
| - | FIXME | + | |
| ====Nevi==== | ====Nevi==== | ||
| * Usually appear in childhood | * Usually appear in childhood | ||
| Line 34: | Line 34: | ||
| * For diffuse disease or tarsal conjunctiva | * For diffuse disease or tarsal conjunctiva | ||
| * Cryotherapy with double freeze-thaw | * Cryotherapy with double freeze-thaw | ||
| + | * Topical interferon alpha-2b | ||
| * Topical mytomycin C 0.02% or 0.04% | * Topical mytomycin C 0.02% or 0.04% | ||
| * QID x 1 week | * QID x 1 week | ||
| Line 43: | Line 44: | ||
| ===Malignant Melanoma=== | ===Malignant Melanoma=== | ||
| + | * Patients are usually 60-70 years old | ||
| + | * Limbus most common but can appear in the caruncle, tarsus or fornix | ||
| + | * Raised mass with feeder vessels | ||
| + | * Treatment | ||
| + | * Avoid incisional biopsy to prevent tumor seeding | ||
| + | * Excision with dry no-touch technique with margins of 4-6 mm | ||
| + | * Cryotreatment to conjunctival edges with double freeze-thaw | ||
| + | * Absolute alcohol to corneal lesions with | ||
| + | * Sclerectomy may be needed for tumors adherent to the sclera applying cautery and cryotherapy to the base | ||
| + | * Closure with primary closure or amniotic graft to cover the defects | ||
| + | * Sentinel node biopsy should be considered for lesions larger than 2 mm or high risk features on histopathology | ||
| + | * Prognosis | ||
| + | * Local recurrence 45% at 5 years and 59% at 10 years | ||
| + | * Mortality: 5-17% at 5 years- 9-35% at 10 years | ||
| + | * Denovo lesions have worst prognosis | ||
| + | * Poorer survival: older age, male, non-white, tumors with nodularity or ulceration. | ||
| ====Summary Table==== | ====Summary Table==== | ||
| Line 54: | Line 70: | ||
| - [[https:// | - [[https:// | ||
| - [[https:// | - [[https:// | ||
| + | - [[https:// | ||