ESCRS - CR26 - PRIMARY ACQUIRED MELANOSIS ASSOCIATED WITH MYCOSIS FUNGOIDES , A CASE REPORT

PRIMARY ACQUIRED MELANOSIS ASSOCIATED WITH MYCOSIS FUNGOIDES , A CASE REPORT

Published 2022 - 26th ESCRS Winter Meeting

Reference: CR26 | Type: Cornea Day Case Presentations | DOI: 10.82333/95hh-hw02

Authors: Mofi Alwalmany* 1 , mohanna aljindan 2 , malak bamashmoos 3 , luluah Bubshait 2

1ophthalmology,Imam abdulrahman alfaisal hospital ,Khobar,Saudi Arabia;ophthalmology,Dhahran eye specialist hospital,Dhahran,Saudi Arabia, 2ophthalmology,Imam abdulrahman alfaisal hospital,Khobar,Saudi Arabia, 3ophthalmology,Dhahran eye specialist hospital,Dhahran,Saudi Arabia

To report a 1st assosiation of Mycosis Fungoides with Primery Acquied melanosis .

Mucosa associated lymphoid tissue ( MALT ) is the most common lymphoproliferative tumors involving the eye and adnexa . Where Mycosis fungoides ( MF ) which is a proliferation of helper T lymphocyte is rarely present with ophthalmic presentation only in  2%  with the eyelid being the most common site of involvement as eyelid ectropion . Here in our case we present a rare case of primary acquired melanosis ( PAM ) present with MF , diagnosis of PAM was made after full surgical excision of the pigmented lesion in the conjunctiva which was sent for histopathology study , where diagnosis of PAM without atypia was made. Up to our knowledge, This is the first reported case of PAM associated with MF

A 33-year-old male known case of mycosis fungoides was diagnosed three years back when he started developing hyperpigmented cutaneous patches over the trunk and extremities. The patient received several sessions of phototherapy and methotrexate.

The patient was referred to the ophthalmology department due to the patient's concern about abnormal localized pigmentation of the left eye that was noticed during the time of skin lesions development. This abnormality did not change in size or pigmentation.

Upon examination, his visual acuity measured in Decimal was 1.0 (20/20) right eye (OD), and 0.5 (20/40) left eye (OS). Slit-lamp examination revealed Left homogenously pigmented conjunctival. The lesion was flat, mobile, and involving the interpalpebral bulbar conjunctiva near the limbus. It measured around 7mm by 5mm . Also, another similar small lesion was found in the conjunctiva of the left eye and the right eye. No palpebral or forniceal conjunctival involvement.  No leukoplakic feature was seen. Cornea, iris, and lens were within normal limits in both eyes. Posterior segment evaluation was insignificant.

The patient underwent surgical excision with a safe margin. Histological diagnosis of primary acquired melanosis (PAM) without atypia ( C-MIN score 1/10 ) was made . The decision of observation with regular follow-up was made. The patient was advised to come back immediately whenever any new abnormality or recurrence occurs. 

This case revealed a 1st association of PAM with MF patient , as we see in this case where a PAM without a atypia developed in the conjunctiva at the same time when MF was diagnosed