RESUMO
PURPOSE: To report the case of a patient who initially presented with primary acquired melanosis (PAM) without atypia of the conjunctiva and later developed lentigo maligna of the eyelids and PAM with atypia of the conjunctiva. We illustrate the utility of combination topical therapy with adjunctive cryotherapy to treat extensive eyelid and conjunctival lesions. METHODS: Case report with a review of the current literature. RESULTS: Combination of imiquimod 5% cream (Aldara, 3M Pharmaceuticals) and cryotherapy for periorbital lentigo maligna with topical interferon-α2b for conjunctival PAM with atypia led to clinical resolution of pigmented lesions for 21 months. CONCLUSIONS: In our experience, combination topical therapy provides an effective alternative to surgery with superior cosmetic and functional outcomes.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doenças da Túnica Conjuntiva/terapia , Crioterapia/métodos , Neoplasias Palpebrais/terapia , Sarda Melanótica de Hutchinson/terapia , Melanose/terapia , Administração Tópica , Idoso de 80 Anos ou mais , Aminoquinolinas/administração & dosagem , Terapia Combinada , Doenças da Túnica Conjuntiva/patologia , Neoplasias Palpebrais/patologia , Feminino , Humanos , Sarda Melanótica de Hutchinson/patologia , Imiquimode , Interferon alfa-2 , Interferon-alfa/administração & dosagem , Melanose/patologia , Proteínas Recombinantes/administração & dosagemRESUMO
Congenital blepharoptosis presents within the first year of life either in isolation or as a part of many different ocular or systemic disorders. Surgical repair is challenging, and recurrence necessitating more than one operation is not uncommon. Not all patients with congenital ptosis require surgery, but children with amblyopia due to astigmatic anisometropia or deprivation may benefit from early surgical correction. A variety of surgical procedures to correct congenital ptosis have been described. The choice of procedure depends on a number of patient-specific factors, such as degree of ptosis and levator function, as well as surgeon preference and resource availability. We review the genetics, associated syndromes, and surgical treatments of congenital ptosis.