J Korean Ophthalmol Soc.  2017 Aug;58(8):896-902. 10.3341/jkos.2017.58.8.896.

Clinical Features of Compound Nevus

• Song H
• Kim DH
• Kim DG
• Cho KJ
• Kwon JW

• KMID: 2388176
• DOI: http://doi.org/10.3341/jkos.2017.58.8.896

Abstract

PURPOSE
To evaluate the clinical features of compound nevus.
METHODS
A retrospective chart review of the medical records for 32 eyes of 32 patients who were clinically diagnosed as having a compound nevus from February 2011 to February 2017 was performed.
RESULTS
The average follow-up period was 21.38 (range, 6-70) months for the 32 patients (9 males and 32 females), and the average age was 21 (range, 7-41) years old. The development or detection of a nevus varied between patients. There were no associated symptoms except for one patient who experienced foreign body sensation. An increase in size was noted in 5 cases (15%). The most common location in the conjunctiva was bulbar in 30 cases (93.8%), and the most common quadrant was temporal in 21 cases (65.6%) followed by nasal conjunctiva in 11 cases (34.4%). The most common locations of anterior margin and posterior margin were on the limbus (56%) and bulbar conjunctiva (92%), respectively. The mean horizontal length was 2.59 ± 1.9 mm and the mean vertical length was 2.62 ± 2.1 mm. All horizontal and vertical lengths were within 5 mm. An elevated nevus was observed in 25 cases (78.1%), and 18 cases (56.3%) had cystic lesions. The color of the nevi were largely brown (26 cases, 81.3%), and 29 cases (90.6%) had feeder vessels. Excisional biopsy and histologic exam were performed in 22 cases (68.8%). The purpose of the treatment was mostly cosmetic (20 cases, 93.8%) or for differential diagnosis with malignant melanoma (2 cases, 6.3%). In the surgery group, no one showed recurrence or any significant complications.
CONCLUSIONS
A conjunctival compound nevus is a benign conjunctival mass and can be found in all age groups. Compound nevus can be diagnosed with clinical features, and complete excision with histological exam is an appropriate treatment to differentiate from malignant melanoma.

Keyword

Clinical features; Compound nevus

MeSH Terms

Biopsy
Conjunctiva
Diagnosis, Differential
Follow-Up Studies
Foreign Bodies
Humans
Male
Medical Records
Melanoma
Nevus*
Recurrence
Retrospective Studies
Sensation

Figure

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  Figure 1 Slit-lamp photographs of compound nevus subtype. Compound nevus which had cystic lesion (A). The color of compound nevus could be pink (B) or yellow (C).

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  Figure 2 Slit-lamp photographs of compound nevus suspecting malignant. Slit-lamp photograph of a 40-year old female patient shows 4.1 mm (average) diameter sized nevus with dark brown color, irregular margin and feeder vessel (A). Slit-lamp photograph of a 40-years old male patients shows 5.0 mm (average) diameter sized elevated nevus with dark brown color with very irregular margin and multiple feeder vessels (B).

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  Figure 3 Slit-lamp photographs of compound nevus before excision and 3 months after excision. Compared to preoperative photographs (A, C, E), postoperative photographs (B, D, F) show complete disappearance of pigmentation and good cosmesis.

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  Figure 4 Slit-lamp photograph and histologic feature of compound nevus. (A) Slit-lamp photograph shows pigmented lesion at bulbar conjunctiva. (B) Histologic features of compound nevus (Hematoxylin and eosin stain, ×100) shows that melanocyte forms a nest shape and melanin pigments are in the epidermis (asterisk) and dermis (arrow) (scale bar: 50 µm).

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  Figure 5 Slit-lamp photograph features of compound nevus previously treated by argon laser photoablation at other clinic. This case shows remaining pigmentation and surrounding conjunctival injection.

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