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Case report
Primary acquired melanosis (PAM) without atypia/WHO low-grade conjunctival melanocytic intraepithelial lesion over areas of oculodermal melanocytosis
  1. Bashar M Bata1,2,
  2. Sachin M Salvi1,2 and
  3. Hardeep Singh Mudhar3
  1. 1Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
  2. 2Department of Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  3. 3Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Dr Bashar M Bata; bbata{at}


An elderly white man with a history of left oculodermal melanocytosis presented with new onset brown pigmentation of the left bulbar and inferior tarsal conjunctiva. The bulbar conjunctival pigmentation was at the level of the conjunctival epithelium and was overlying areas of typical slate-grey scleral pigmentation characteristic of oculodermal melanocytosis. Both areas of new pigmentation were biopsied. The bulbar conjunctiva revealed primary acquired melanosis (PAM) without atypia with increased melanin production and the tarsal conjunctival biopsy showed PAM without atypia sine pigmentio overlying areas of substantia propria spindle-shaped heavily pigmented melanocytes of oculodermal melanocytosis. The case report examines the relationship between the epithelial and substantia propria melanocytes and correlates the findings with what is known about this association from the dermatopathology literature.

  • ophthalmology
  • pathology

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  • Contributors BMB collected the information and figures and wrote the manuscript. SMS contributed to the concept of the report as well as edited the manuscript and figures. HSM wrote sections of the text relating to the histopathology and comparative dermatopathology discussion and all histology data and figures.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.