Actinic granuloma of the conjunctiva

The key histologic feature of pingueculas is the presence of actinic elastosis of the conjunctival connective-tissue fibers. We describe a patient who had a pinguecula that, on pathologic examination, exhibited a prominent foreign-body giant-cell reaction in association with the elastotic fibers. The term actinic granuloma has been coined recently to designate a similar reaction in sun-damaged skin. Because the nature of the inflammatory reaction may be misinterpreted on pathologic examination as indicating the presence of microorganisms or a foreign body, both the clinician and the pathologist should be aware of this peculiar inflammatory response, which has been described on two previous occasions in patients with pingueculas.