All Eyes on Dermoscopy: Features of Benign Conjunctival Melanocytic Lesions

Dimitrios Sgouros; Panagiota  Theofilogiannakou; Georgia Pappa; Konstantinos Liopyris; Eftychia  Kitsiou; Anna Syrmali; Sofia Theotokoglou; Emmanouil Karampinis; Aimilios Lallas; Zoe Apalla; Alexander Katoulis

doi:10.5826/dpc.1504a5596

All Eyes on Dermoscopy: Features of Benign Conjunctival Melanocytic Lesions

Authors

Dimitrios Sgouros 2nd Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School ,“Attikon” General University Hospital, Athens, Greece https://orcid.org/0000-0003-0009-8821
Panagiota Theofilogiannakou 2nd Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School ,“Attikon” General University Hospital, Athens, Greece / Dermatology and Venereology Department, General Hospital of Athens, “Evangelismos”, Athens, Greece https://orcid.org/0009-0005-5815-7726
Georgia Pappa 2nd Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School ,“Attikon” General University Hospital, Athens, Greece https://orcid.org/0000-0001-6932-1441
Konstantinos Liopyris 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School, Andreas Sygros Hospital, Athens, Greece https://orcid.org/0000-0001-9566-8238
Eftychia Kitsiou 2nd Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School ,“Attikon” General University Hospital, Athens, Greece
Anna Syrmali 2nd Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School ,“Attikon” General University Hospital, Athens, Greece https://orcid.org/0000-0003-3701-1822
Sofia Theotokoglou 2nd Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School ,“Attikon” General University Hospital, Athens, Greece https://orcid.org/0000-0002-9076-3866
Emmanouil Karampinis Department of Dermatology, University of Thessaly, Medical School, University Hospital of Larissa, Larissa, Greece https://orcid.org/0009-0007-4130-3306
Aimilios Lallas 1st Department of Dermatology-Venereology, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece https://orcid.org/0000-0002-7193-0964
Zoe Apalla 2nd Department of Dermatology-Venereology, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece https://orcid.org/0000-0002-9255-8196
Alexander Katoulis 2nd Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School ,“Attikon” General University Hospital, Athens, Greece https://orcid.org/0000-0001-8189-7486

Keywords:

Dermoscopy, Conjunctiva, Melanocytic Lesion, Ocular Pigmentation, Nevus

Abstract

Introduction: Conjunctival nevi (CN) represent the majority of benign conjunctival melanocytic lesions (CML), followed by complexion-associated melanosis (CAM). Noninvasive methods like dermoscopy could be of importance to increase diagnostic accuracy in this biopsy-sensitive area. Because of the unique anatomy of the conjunctiva, dermoscopic findings differ significantly compared to the skin or other mucosae.

Objective: Our objective was to analyze epidemiological, clinical, and dermoscopic characteristics of benign conjunctival melanocytic lesions and to explore their correlation to total body nevus count (TBNC).

Methods: This retrospective study involved the collection and analysis of demographic data, patient information, and clinical and dermoscopic images from individuals with long-standing, stable, pigmented conjunctival lesions.

Results: A total of 30 benign conjunctival melanocytic lesions in 28 patients (female/male :18/10) with a median age of 32 (range 16–68) years were evaluated. The prevalent dermoscopic pattern was a mixed, globular, homogeneous pattern (36.6%). Clear cysts were identified via dermoscopy in 60% of the lesions, and a reticular pattern was observed in all cases involving cysts (P<0.05). The presence of benign CML was associated with a low TBNC (<10) in 64.3%.

Conclusions: The present study provides a detailed overview of the clinical and dermoscopic characteristics of benign CML. It highlights consistent patterns such as cyst-associated reticular features and a low TBNC among affected individuals. These findings support the clinical utility of dermoscopy as a noninvasive tool for differentiating between benign and suspicious conjunctival lesions. The observed association with low TBNC may warrant increased vigilance during ocular examination in patients with few cutaneous nevi. Prospective studies with larger cohorts are needed to confirm and extend these observations.

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