Use of interferon alpha 2b to manage conjunctival primary acquired melanosis and conjunctival melanoma

Primary acquired melanosis (PAM) is acquired conjunctival pigmentation that can give rise to conjunctival melanoma (CM), a malignant tumor of the bulbar and palpebral conjunc-tiva or the caruncle. Surgical excision is the treatment of choice for this neoplasm. Topical chemotherapy is also used for patients with PAM with atypia or CM and, in patients with recurrent or extensive disease, this may be an important option. Of the several chemother-apeutic drugs used, topical interferon alpha 2b (IFN-a2b) has become popular because of its low toxicity. Clinical evidence from case reports and case series supports the efficacy of IFN-a 2b as the preferred adjuvant treatment for PAM and CM. In addition, topical IFN-a 2b has been successfully applied to melanocytic tumors refractory to other treatments, such as cryotherapy and topical mitomycin C. In patients with locally advanced CM, the combina-tion of IFN-a 2b and systemic immunotherapy may serve as an alternative to exenteration. Given the low frequency of CM, long-term multicenter studies are needed to demonstrate the efficacy of IFN-a 2b for preventing local recurrence and distant metastasis.(c) 2022 Elsevier Inc. All rights reserved.

Automated summary

Primary acquired melanosis (PAM) is a conjunctival pigmentation that can lead to conjunctival melanoma (CM). Surgical excision is the preferred treatment, but topical chemotherapy with interferon alpha 2b (IFN-a2b) is also an important option. IFN-a2b has shown efficacy in treating PAM and CM, with low toxicity.