Primary acquired melanosis: A unique presentation

Abstract

to report a case of PAM with atypical presentation We are reporting a case of a 45 years old male who presented to the outpatient department of Ophthalmology with complaints of sudden onset watering and foreign body sensation in the right eye. Detailed slit lamp examination revealed an elevated pigmented lesion of the conjunctiva in the nasal quadrant extending up to 2 clock hours. Excision biopsy was done and histopathological examination found the lesion to be moderate grade dysplastic conjunctival PAM. Primary acquired melanosis (PAM) is an acquired disorder of the conjunctiva characterized by a flat brown pigmentation of the conjunctival epithelium. It may be analogous to lentigo maligna — a preinvasive epidermal pigmentation of skin. It presents as a unilateral patchy area of conjunctival pigmentation mostly seen in middle aged or elderly light skinned individuals with a potential for malignant transformation.