Objective: To report the clinical and histologic features of combined nevi
of the conjunctiva, a type of nevus that is not uncommon in the skin but ra
rely has been reported in the conjunctiva.
Methods: Conjunctival nevi and melanomas in the files of the University of
California at San Francisco Eye Pathology Laboratory from 1984 to 1999 were
reviewed for the presence of features of both standard nevocytic nevi and
blue nevi. Clinical histories and, when available, clinical photographs wer
e obtained.
Results: Thirty combined nevi were discovered between 1984 and 1999. One ca
se before 1984 had been incorrectly diagnosed as a junctional nevus. The de
ndritic and spindle-shaped blue nevus cells had been over-looked because th
ey were not recognized as distinct from the standard nevocytic nevus cells.
The recognition of blue as well as a brown color, a deep as well as a supe
rficial component in the lesion, or a history of pigmentation since birth m
ay help to establish the correct clinical diagnosis and prevent an unnecess
arily deep surgical resection. Although growth of the lesion or "satellites
" in some may favor a clinical diagnosis of melanoma, no lesions in this se
ries were malignant.
Conclusion: Despite a paucity of reports of combined nevi of the conjunctiv
a in the medical literature, this type of nevus, a combination of a nevocyt
ic and a blue nevus, is common and has been overlooked in the past.