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A. Nava-Castaneda, J. Tovilla-Canales., R.I. Flores, J. Tovilla-y-Pomar, O. Schneider; Use of Mitomycin C in the Treatment of Conjuntival Primary Acquired Melanosis With Atypia . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3795.
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Primary acquired melanosis (PAM)is a flat, brown, superficial discoloration caused by intraepithelial melanocytes of the conjunctiva. Histologically, PAM can be differentiated in without atypia which is a benign disease, or with atypia that has shown to have a high risk of melanoma, and needs to be eliminated. Treatment for PAM with atypia includes resection and cryotherapy. Unfortunately, these treatments have severe limitations and complications. Recently,use of topical mitomycin C (MMC) in the treatment of PAM with atypia has shown promising results in some series. However, long term follow-up in these sereies are lacking. Purpose: To evaluate a long term follow-up of patients with PAM with atypia treated with MMC. Methods: Two hispanic patients with histopathological diagnosis of PAM with atypia were treated with MMC (0.02%) four times a day for 15 days. After a resting period of 15 days without medication, a second treatment with MMC (0.02%) qid for another 15 days was given. Patients have been followed-up with a complete ophthalmological evaluation and conjuntival biopsy for the last 5 years. Results: Pigmentation of the conjunctiva substantially improved after the first phase of the treatment. Biopsies performed annually since then, have revealed a decreases presence of melanophagus, decreased mitosis, and no presence of atypical melanocytes. No adverse reactions other than mild keratoconjunctivitis that presented during the treatment phase ocurred. Conclusions: MMC at 0.02% showed to be an effective treatment for PAM with atypia at a 5 years follow-up in our series.
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