Diagnosis: Conjunctival melanoma
Photo taken by Dr. Ed Uthman
Photo taken by Dr. Ed Uthman
Submitted by dermRounds Dermatology Network. Originally posted June 21, 2008.
See case discussion.
• Dysplastic (atypical) nevus • Seborrheic keratosis • Blue nevus • Pigmented basal cell carcinoma • Pigmented dermatofibroma • Thrombosed hemangioma • Solar lentigo
• ABCDE criteria: Asymmetry, Border irregularity, Color variation, Diameter >6mm, Evolving • "Ugly duckling sign" — the lesion that looks different from the patient's other moles • Breslow thickness is the single most important prognostic factor • Sentinel lymph node biopsy recommended for lesions ≥0.8mm or with ulceration • Subtypes: superficial spreading (most common), nodular, lentigo maligna, acral lentiginous • Acral lentiginous melanoma: most common type in dark-skinned individuals — check palms, soles, nails • Hutchinson sign in subungual melanoma: pigment extending to nail fold • Immunotherapy (anti-PD-1, anti-CTLA-4) and targeted therapy (BRAF/MEK inhibitors) revolutionized treatment of advanced melanoma
Tags: conjunctival, melanoma, dermrounds dermatology network