Solitary Intratarsal Blue Nevus

Area of Science:

• Ophthalmology
• Dermatopathology
• Oncology

Background:

• Pigmented lesions of the palpebral conjunctiva require careful evaluation due to the potential for melanoma.
• Early detection and complete excision are crucial for managing suspicious eyelid lesions.

Observation:

• A 42-year-old woman presented with a small, asymptomatic pigmented lesion on the palpebral conjunctiva.
• The lesion was surgically removed due to clinical suspicion of melanoma.

Findings:

• Microscopic examination revealed an intratarsal blue nevus involving the meibomian glands.
• The nevus comprised bland spindle and epithelioid cells, immunoreactive for Melan-A, with a negative Ki67 proliferative index.
• Absence of significant cellular proliferation and presence of melanophages supported a benign diagnosis, distinguishing it from melanoma.

Implications:

• This case highlights the occurrence of a solitary tarsal blue nevus, distinct from previously described combined nevi.
• It underscores the importance of surgical excision for accurate diagnosis of palpebral pigmented lesions.
• Pathological confirmation is essential to differentiate benign nevi from malignant melanoma of the conjunctiva.