Malignant melanomas of the conjunctiva.

A retrospective study of 23 conjunctival melanomas using the Clark classification revealed that the three most common forms of melanoma described in the skin--lentigo maligna melanoma (Hutchinson's freckle with melanoma), superficial spreading melanoma, and nodular melanoma--can be recognized in the conjunctiva. As in the skin, lentigo maligna melanoma appears to be associated with a good prognosis compared to the prognosis associated with superficial spreading melanoma. These two forms of melanoma are both associated with an intraepithelial stage and had previously been grouped under one designate, cancerous melanosis. They can be distinguished histologically although definite clinical differentiation will be determined in the future. Some melanomas with an intraepithelial stage, however, cannot be definitely classified. Relating all conjunctival cancerous melanoses to Hutchinson's melanotic freckle is no longer justified.