Kaposi's Sarcoma: nodular mass varying in color from purplish-red to brown. Systemic association = AIDS. This is rarely the presenting sign however. Those AIDS patients with HLADR5 phenotype are at increased risk.
HBID = Triracial family from North Carolina. Systemic association = genetically inherited
MALT Lymphoma – Fills inferior or superior fornix. Systemic association = lymphoma
Solid tumor mets – metastasis to conjunctiva (e.g. Systemic association = adenoCA breast)
Conjunctival Papilloma – Viral induced vs malignant (Squamous cell CA). Systemic associations = Some associated with systemic HPV infection.
GUIDELINES FOR DISTINGUISHING BENIGN FROM MALIGNANT PAPILLOMAS
Melanoma of the Conjunctiva- Arise from 3 sources.
1. 20% from nevi (primarily nevocellular) 2. 40% from acquired melanosis 3. 40% de novo
Occur most often in middle-aged caucasians. Most often near the limbus. Those rarer tumors arising in palpebral conjunctiva generally have a less favorable prognosis. Characterized by slow superficial growth. Other than tumor thickness, few prognostic indicators for 5 yr survival available. Can't be classified according to Callender classification or Clark system used for skin melanomas.
Lesions at the Lid Margin and Muco-cutaneous Junction (Pearl: Disortion of lash line as soft indicator of benign vs malignant.)
Solitary Mollsucum contagiosum – unique morphology and associated viral conjunctivitis Systemic association = HIV or other immunocompromise.
Verruca – unique morphology and associated viral conjunctivitis. Systemic association = None
Sebaceous gland CA – Two clinical masquerades (recurrent chalazion or unilateral moderate blepharitis. Systemic associations = none unless mets
Granulomata along lid margin – Systemic association = Sarcoidosis