Conjunctival Melanoma: A New Clinical and Therapeutical Approach

Melanoma involving the conjunctiva is extremely rare. Graver prognosis has been reported with primary conjunctival melanoma than with their cutaneous counterparts [Collin et al.: Aust N Z J Ophthalmol 1986;14:29-34]. Among conjunctival melanomas, two significant risk factors for tumour-related death have been identified: (i) age older than 55 years and (ii) unfavourable tumour location (caruncle, cornea, fornix, palpebral conjunctiva) [Werschnik and Lommatzsch: Am J Clin Oncol 2002;25:248-255]. Here we present a rare case of lentigo maligna involving the palpebral, bulbar conjunctiva and the caruncle. We describe dermoscopic patterns observed and the use of a novel ocular melanoma therapy with topical imiquimod.