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Corneal dysplastic melanosis associated with recurrent corneal erosions: A case report

Hyo Kyung Lee1,2, Cheol Lee3, Mee Kum Kim1,2

  • 1Department of Ophthalmology, Seoul National University College of Medicine.

Medicine
|December 22, 2018
PubMed
Abstract

Insights

Primary acquired dysplastic melanosis of the cornea can disrupt the corneal barrier, leading to recurrent corneal erosions. Surgical intervention resolved symptoms in a patient with this rare condition.

Area of Science:

  • Ophthalmology
  • Dermatology
  • Oncology

Background:

  • Pigmented lesions of the conjunctiva and cornea range from benign nevi to malignant melanoma.
  • Primary acquired melanosis (PAM) is a neoplastic proliferation of melanocytes with malignant potential.
  • Corneal PAM causing epithelial barrier dysfunction and recurrent corneal erosions has not been previously reported.

Observation:

  • A 60-year-old woman presented with a 4-month history of recurrent corneal erosions in her left eye.
  • Slit-lamp examination revealed pigmented lesions with loose epithelium scattered across the corneal epithelial layer.
  • Conservative treatments failed to resolve the corneal erosions.

Findings:

  • Histopathology confirmed pigmented melanocytes with mild atypia in the corneal basal epithelium, diagnosed as primary acquired dysplastic melanosis.
  • The condition caused significant epithelial barrier dysfunction.
  • En bloc resection of the pigmented epithelium with cryotherapy and amniotic membrane transplantation was performed.

Implications:

  • Surgical intervention successfully resolved the recurrent corneal erosions and epithelial loosening.
  • Primary acquired dysplastic corneal melanosis can lead to epithelial dysfunction and recurrent corneal erosions.
  • This case highlights a novel presentation of corneal PAM and its successful management.

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