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Updated: Apr 21, 2026
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Published on: December 2, 2022
Combination topical therapy for conjunctival primary acquired melanosis with atypia and periocular lentigo maligna
Emily M Bratton1, Siri Knutsen-Larson, Vikram D Durairaj
1*Department of Ophthalmology, University of Colorado, Aurora, CO; †Department of Dermatology, University of Colorado, Aurora, CO; ‡Texas Oculoplastic Consultants, Austin, TX; §Department of Ophthalmology, Division of Corneal and External Disease, University of Colorado, Aurora, CO; and ¶Department of Moh's Micrographic Surgery, University of Colorado, Aurora, CO.
Purpose:
To report the case of a patient who initially presented with primary acquired melanosis (PAM) without atypia of the conjunctiva and later developed lentigo maligna of the eyelids and PAM with atypia of the conjunctiva. We illustrate the utility of combination topical therapy with adjunctive cryotherapy to treat extensive eyelid and conjunctival lesions.
Methods:
Case report with a review of the current literature.
Results:
Combination of imiquimod 5% cream (Aldara, 3M Pharmaceuticals) and cryotherapy for periorbital lentigo maligna with topical interferon-α2b for conjunctival PAM with atypia led to clinical resolution of pigmented lesions for 21 months.
Conclusions:
In our experience, combination topical therapy provides an effective alternative to surgery with superior cosmetic and functional outcomes.
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