Resolution of primary acquired melanosis with atypia after treatment with topical mitomycin C and interferon alfa-2b

Purpose: to report a case of primary acquired melanosis (pam) successfully treated with combined topical mitomycin c and interferon-α2b. case report: a 75-year-old man presented with an extensive unilateral pigmented lesion involving 360° of the bulbar conjunctiva,extending to the fornices and palpebral conjunctiva. map biopsy confirmed pam with local atypia. treatment was initiated with mitomycin c 0.04% eye drops for two courses. although the lesion markedly responded to the treatment,residual lesions justified further therapy. to avoid ocular surface toxicity induced by excessive mitomycin c exposure,interferon-α2b eye drops were started and continued for 6 months. the pigmented lesion almost completely disappeared and no significant complication or recurrence was observed for 24 months. conclusion: combination therapy using mitomycin c and interferon-α2b for pam with atypia may be recommended as an effective treatment modality,avoiding the ocular surface toxicity due to excessive mitomycin c exposure.