[Treatment of primary acquired melanosis of the conjunctiva]

The progression to malignancy of primary acquired melanosis of the conjunctiva with cytologic atypia is often insidious and may not be recognized clinically. Because of the bad prognosis of such melanomas, destruction of the intraepithelial lesion has been recommended. We have been freezing proliferative melanosis with the aid of a cryoprobe. A double freeze-thaw cycle at -70 degrees to -80 degrees was sufficient to destroy the epithelium and eradicate atypical melanocytes without serious complications. Focal nodules, arising in acquired melanosis representing invasive melanomas, however, should be excised initially. Cryotherapy may then be applied to the base and surroundings of the tumor.