You are here

  • Home
  • Online First
  • Primary acquired melanosis with spill over periocular lentigo maligna: 19-year outcomes at a specialist eyelid and ocular oncology centre

Article Text

Article menu
Download PDFPDF
Oculoplastic and orbit
Clinical science
Primary acquired melanosis with spill over periocular lentigo maligna: 19-year outcomes at a specialist eyelid and ocular oncology centre
  1. Mumta Kanda1,
  2. Allan Zhifa Nghiem1,
  3. Fariha Shafi2,
  4. Shirin Hamed Azzam1,3,
  5. Tarang Gupta1,
  6. Claire Daniel1
  1. 1 Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2 Adnexal, East and North Hertfordshire NHS Trust, Stevenage, UK
  3. 3 The Baruch Padeh Medical Center Poriya, Tiberias, Israel
  1. Correspondence to Mumta Kanda; mumta.kanda1{at}nhs.net

Abstract

Background/aims There is a paucity in the literature on the presentation, management and outcomes of cases where primary acquired melanosis (PAM) is associated with spill over/contiguous periocular lentigo maligna (LM). We describe experience of such cases at our eyelid and ocular oncology specialist centre.

Methods We conducted a retrospective consecutive case review of adult patients with PAM and periocular LM between 2005 and 2024 at Moorfields Eye Hospital in London. Demographic data, diagnosis, histology, imaging, treatment, surgical notes, outcomes and follow-up were collected from the electronic patient record.

Results Of 21 patients identified, 100% were Caucasian, 13 (62%) were women and the average age of diagnosis was 67 years. Grade of PAM atypia was mild in 5 (24%), moderate in 2 (9%) and severe in 14 (67%) patients. 16 (76%) patients developed melanoma (all types) and 12 (57%) patients developed conjunctival melanoma. Of those with PAM with severe atypia, 93% developed melanoma. The average time interval from diagnosis of PAM and LM to melanoma was 72 months. Melanoma recurrence occurred in 7 (44%) and metastases developed in 4 (25%) patients. Four patients died, including two from metastatic melanoma. Average follow-up length was 129 months.

Conclusions PAM with atypia, particularly severe atypia, when associated with spill over periocular LM, may have significant risk of progression to melanoma. Patients with PAM require careful eyelid examination to identify LM. Management requires multidisciplinary input, urgent biopsy and confocal microscopy if available, lower threshold for treatment and lifelong monitoring.

  • Eye Lids
  • Prognosis
  • Risk Factors
  • Treatment Surgery
  • Treatment Medical

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data are available upon reasonable request.

https://doi.org/10.1136/bjo-2024-326691

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data are available upon reasonable request.

    View Full Text

    Footnotes

    • Contributors MK designed the study protocol, collected data, analysed data and wrote the manuscript. AZN assisted with data collection, data analysis and supervised the writing of the manuscript. FS and SHA assisted with data collection and reviewed the manuscript. TG reviewed the manuscript. CD supervised the project from start to finish and is the study guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.