Topical mitomycin treatment for primary acquired melanosis of the conjunctiva

A case of primary acquired melanosis of the conjunctiva primarily treated with topical mitomycin chemotherapy is presented. The patient underwent treatment with one 2-week course of topical mitomycin 0.02% four times daily, followed 4 weeks later by a 2-week course of topical mitomycin 0.04% four times daily, followed by a 3-month course of topical mitomycin 0.02% twice daily. Map biopsies were performed after the initial two courses of mitomycin therapy and 12 months after all courses of mitomycin treatment had been completed. Complete resolution of the conjunctival pigmentation was noted after the final course of treatment. Map biopsies performed at 12 months following completion of treatment showed normal conjunctiva histopathologically. No recurrence of pigmentation was noted in follow-up 26 months after completion of treatment. Topical mitomycin chemotherapy may be a successful primary treatment for primary acquired melanosis of the conjunctiva.