Pigmented conjunctival neoplasms.

Pigmented lesions of the conjunctiva are not rare. They may be acquired, congenital, benign or malignant. In the present paper, the author provides a brief review, in a non-exhaustive manner, of the common melanocytic pigmentations, with more emphasis on the malignant and pre-malignant variants.

Ocular findings in patients with dysplastic nevus syndrome. An update.

Two hundred fifty-seven patients with biopsy-proven dysplastic nevus syndrome (DNS) were evaluated ophthalmologically and compared with 264 non-DNS patients, who acted as a control population. A statistically significant increase in the percentage of the DNS patients versus controls harboring conjunctival nevi (8.56% vs.

Lower eyelid reconstruction.

The Hughes procedure of tarsoconjunctival flap sharing for lower eyelid reconstruction following removal of basal cell carcinoma is described. Although this technique has the disadvantage of being a 2-staged procedure that requires closure of the eyelid for 2-8 weeks, its cosmetic and functional results are outstanding. While the Hughes procedure is not the only technique for eyelid reconstruction, it is a time-tested method commonly practiced by ophthalmic plastic surgeons.

Radiotherapy of periocular basal cell carcinomas: recurrence rates and treatment with special attention to the medical canthus.

Basal cell carcinomas of the eyelids, especially those in the medial canthal area, may cause extensive local destruction. Recurrent tumours are more aggressive and become progressively more difficult to treat; this is especially true for postirradiated recurrent, medial canthal, basal cell carcinomas. Tumours in this area should thus be treated by a technique which allows tissue sampling in order to gauge the adequacy of the treatment, with the goal being complete extirpation of the tumour.

Ocular findings in patients with dysplastic nevus syndrome.

Ninety-two patients with biopsy-proven dysplastic nevus syndrome were evaluated ophthalmologically and compared to a non-dysplastic nevus syndrome control population. A statistically significant increase in the percentage of dysplastic nevus syndrome patients versus controls harboring conjunctival nevi (9.78% vs.

Mohs surgery for periocular basal cell carcinomas.

Cure rates for 631 periocular basal cell carcinomas treated by Mohs surgery proved to be 98.1% for primary lesions and 93.6% for previously treated lesions.

Ocular melanomas.

The importance of melanomas of the eye and adnexa is that they can be as deadly as the most aggressive cutaneous types, with 15-year mortality rates approaching 50 per cent. Also, treatment may permanently impair the sight. This discussion of melanomas that affect the eye and adnexa commences with the eyelids, proceeds to the conjunctiva, follows with the ocular globe, and includes a consideration of the dysplastic nevus syndrome as it affects the eye.

Ophthalmologic oncology: sebaceous carcinomas of the eyelids.

Sebaceous carcinomas are rare, and deadly, adnexal tumors with a distinct predilection for eyelid skin. A chronic blepharoconjunctivitis and/or a recurrent chalazion are the most common clinical presentations that should alert the clinician to the diagnosis. Great care and skill are needed in interpreting these lesions histopathologically as they can be easily confused with basal- and squamous-cell carcinomas.

Ophthalmologic oncology: alopecia of the eyelashes.

The variety of lesions that can cause alopecia of the eyelashes (Table 1) demonstrates the need for accurate diagnosis. A full-thickness biopsy of lid margin with appropriate three-suture closure can leave an imperceptible defect and may provide invaluable information. Although a partial-thickness lid biopsy is certainly appropriate for many common eyelid tumors such as basal-cell carcinomas or nevi, we feel strongly that a full-thickness lid biopsy is indicated when discussing chronic eyelid lesions that cause alopecia.

"Small" melanomas: relation of prognostic variables to diameter of primary superficial spreading melanomas.

In a consecutive series of 648 superficial spreading melanomas a significantly better 5-year disease-free survival rate was observed for patients whose primary tumors were 14 mm or less in diameter when compared with those 15 mm or larger in diameter. Other distinguishing features of the group of "smaller" superficial spreading melanomas were that they occurred in younger patients; were of shorter durations; were more common in women; occurred disproportionately on the lower limbs; were less elevated; tended to be round in shape; were thinner (Breslow); penetrated less deeply (Clark levels); showed less histologic regression; and developed fewer metastases. Based on these findings it is recommended that educational programs be undertaken for the medical profession and for the public to promote early diagnosis and prompt treatment of superficial spreading melanomas when they are small in diameter and more often curable.

Lentigo maligna of the lateral canthal skin.

An elderly patient with a large, acquired macular pigmented lesion on the skin of the left lateral canthus is described. Clinically, the lesion was consistent with lentigo maligna and total excision was performed. Histopathologic examination revealed atypically melanocytic proliferation at the dermal-epidermal junction without dermal invasion.