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Cornea & External Diseases

















Primary Acquired Melanosis (PAM)

  • Typically develops in middle-aged or elderly white patients.
  • Clinical features:
    • Almost always unilateral
    • Uni- or multifocal, flat, indistinct areas of conjunctival pigmentation
    • Commonly involves the inferior or superior fornices
    • May remain stable over years, become smaller, undergo color changes or malignant transformation
  • Work up: multiple biopsies are sometimes required to define the cytological status of the lesions.
  • Management:
    • Regular follow-up with photographic documentation.
    • Local excision with or without extensive cryotherapy should be performed if the lesion becomes thicker and demonstrates invasive nodular formation.

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