Benign melanosis

Author: Deepali Jain, M.D. (see Authors page)

Revised: 18 April 2018, last major update March 2013

Copyright: (c) 2004-2018, PathologyOutlines.com, Inc.

PubMed Search: melanosis [title] benign eye

Related Topics: Primary acquired melanosis

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Cite this page: Jain, D. Conjunctiva: benign melanosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/eyebenignmelanosisconj.html. Accessed March 25th, 2019.
Definition / general
  • Pigmented thickening of conjunctival epithelium, may be normal finding in dark skinned individuals - bilateral, continues throughout life (Surv Ophthalmol 2004;49:3)
  • Present in 92% of blacks, 36% of Asians, 28% of Hispanics, 5% of whites
  • Uncommon finding in Laugier-Hunziker syndrome (Arch Dermatol 2007;143:631)
  • Can be cystic (Cornea 2012;31:1273)
Clinical images

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Laugier-Hunziker syndrome

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Dermoscopic examination of mucosal lesions

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Parallel furrow pattern of pigmented macules

Microscopic (histologic) description
  • Dense pigmentation at basal layer of epithelium but normal number of melanocytes
  • Cystic variant has epithelial lined cysts with goblet cells in substantia propria
Microscopic (histologic) images

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Dendritic melanocytes
are present in
racial melanosis

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Hyperpigmentation of
basal keratinocytes and
melanophage population
Negative stains
Differential diagnosis
  • Early primary acquired melanosis: melanocytic proliferation is present
  • Iron containing foreign bodies
  • Medications: epinephrine, tetracycline, silver containing products
  • Melanocyte migration associated with inflammation or trauma
  • Ochronosis
  • Ocular melanocytosis: pigmentation of ocular structures due to abnormal migration of melanocytes during development
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