Adult Ocular and Orbital (Ocular Adnexa) Tumors
Pat Price, Karol Sikora in Treatment of Cancer, 2020
Melanocytic tumors are mainly nevocellular nevi, which are common in the skin of the eyelids and must be distinguished from pigmented basal-cell and squamous-cell lesions. Occasionally, a divided nevus is encountered that occupies the adjacent margins of both upper and lower eyelids and that has arisen from a single nevus by separation of the eyelids in embryonic life. Nevocellular nevi are best managed by infrequent observation. In oculodermal melanocytosis (nevus of Ota), there is widespread infiltration of the eyelid skin and of all ocular structures with plump melanocytes. The condition is most common in individuals of Asian and African extraction. Malignant change does not occur in the cutaneous element of nevus of Ota, but as well as being associated with an increased incidence of intra-ocular melanoma it may very occasionally be linked with the development of a primary orbital melanoma. Benign conjunctival nevi are frequently cystic. They are easily excised and, bearing in mind that malignant change can occur, this option should be considered as an alternative to long-term follow-up.
Laser Treatment on Ethnic Skin
Henry W. Lim, Herbert Hönigsmann, John L. M. Hawk in Photodermatology, 2007
Hori’s macules differ from nevus of Ota because they occur in adults, are bilateral rather than unilateral, and have no mucosal involvement. Hori’s macules are thought to occur due to a range of aetiological factors such as sex hormones, ultraviolet light exposure, and trauma, which lead to a dropping off of the hair follicular melanocytes to the dermis. Frequently, Hori’s macules coexist with other pigmentary conditions, such as melasma and lentigines. QS ruby, QS Alex, and 1064 nm Nd:YAG lasers have been shown to be effective in the treatment of this condition (41–43). However, previous studies indicated that Hori’s macules are more resistant to treatment than nevus of Ota and require shorter treatment intervals and more treatment sessions before the lesions gradually subside. Transit pigmentary disturbance is the main adverse effect, with hyperpigmentation particularly common during the first few treatment sessions. Recently, it was proposed to combine QS 532 nm Nd:YAG and QS 1064 nm Nd:YAG to obtain a greater degree of improvement (44) (Fig. 4).
Lasers
Dimitris Rigopoulos, Alexander C. Katoulis in Hyperpigmentation, 2017
Nevus of ota is a benign congenital dermal melanocytic nevus that is usually located unilaterally in the V1 and V2 distribution of the face. This lesion occurs mainly in darker skin types, especially Asians, and predominantly in women.43 While nevus of ota usually follows a benign course, patients should be followed closely as there are rare reports of malignant melanoma developing in these lesions. In cases where nevus of ota involves the eye, there have been reports of glaucoma and uveal melanoma.43 Other dermal melanocytosis includes the less common nevus of ito located on the posterior supraclavicular, scapular, and deltoid regions, and this lesion can be treated similar to nevus of ota.44
Clinical and genetic characteristics of nevus of Ota with choroidal melanoma in Chinese
Published in Ophthalmic Genetics, 2019
The exact etiology of nevus of Ota is still unknown. Although familial cases are rare, there may be an underlying genetic predisposition (13,14). Dr. Konstantinov found that GNAQ and BAP1 mutations in patients with nevus of Ota confer a greater risk for malignant melanoma and metastatic progression (7,15,16). In our series, we found two suspicious gene mutations involving FAM111B and DSC2 that might contribute to the etiology of the disease. The missense variants c.304T>C (p. Tyr102His) and c.2608G>C (p. Gly870Arg) were discovered in FAM111B and DSC2, respectively, according to our results. FAM111B is located in 11q12.1 and encodes a protein with a trypsin-like cysteine/serine peptidase domain in the C-terminus. Mutations in FAM111B are associated with hereditary fibrosing poikiloderma (HFP) (5). There is no current evidence to prove that FAM111B is associated with nevus of Ota. However, individuals with these gene mutations could display mottled pigmentation, which might indicate some relationship between FAM111B and nevus of Ota. DSC2, which is located in 18q12.1, encodes a member of the desmocollin protein subfamily. Mutations in this gene are associated with arrhythmogenic right ventricular dysplasia, reduced protein expression in several types of cancer, and tumor progression in esophageal cell carcinoma, gastric cancer, colon cancer, etc (6). No previous findings indicate whether DSC2 plays a role in nevus of Ota. DSC2 may be a new breakthrough for the disease. Further studies should identify the relationship between DSC2 and nevus of Ota.
Primary orbital melanoma: A report of a case and comprehensive review of the literature
Published in Orbit, 2021
Modupe O. Adetunji, Brendan McGeehan, Vivian Lee, Maureen G. Maguire, César A. Briceño
A total of 254 articles were identified. After screening for case series and case reports meeting inclusion criteria, 32 papers describing a cumulative total of 88 patients with primary orbital melanoma, including the case described above, were included in this review. Demographic and clinical information is presented in Table 1. The mean age at presentation was 45.1 years (range 5–91, median 45). Males were affected more often than females (58% and 42%, respectively), although this difference was not statistically significant. Most individuals were of white European descent (95%). There was no significant difference in laterality of the tumor (58% left-sided, 42% right-sided). Ocular melanosis or nevus of Ota was present in 24% of cases.
A retrospective analysis of the clinical efficacies and recurrence of Q-switched Nd:YAG laser treatment of nevus of Ota in 224 Chinese patients
Published in Journal of Cosmetic and Laser Therapy, 2018
Yan Liu, Weihui Zeng, Di Li, Weihua Wang, Feng Liu
After successful laser treatment, 224 patients were followed up by telephone each year. The follow-up period ranged from 2 to 10 years. The Ota reappeared in eight patients (seven females, one male). All the recurrence lesions occurred in the initial position, and smaller than the previously treated site. The time of recurrence was 1–3 years after the latest treatment session. The predominant color of the reappeared lesions was blue-black (5/8), and lesion Type I, II (Tanino classification) all had recurrence. Recurrence is rare in nevus of Ota. The recurrence rate after treatment is extremely low as 0.8–2.1% in several retrospective studies (9,15). Recurrences usually develop at the previous site. However, they might appear beyond the previously treated site (16). The exact reason for recurrence of nevus of Ota remains unclear. It was previously reported that multipotent dermal stem cells (DSCs) might differentiate into functional melanocytes, which might be etiologic factors of pigmentary disorder (3,17,18). Lee et al. (16) speculated that DSCs remained after the laser treatment and unknown factors may trigger differentiation of the DSCs into functional melanocytes, which might play a role in the reappearance of nevus of Ota. Sun exposure and pregnancy may be considered as the possible reasons of recurrence (19). Two patients in our study had excessive sun exposures and one patient recurred after pregnancy. Two recurrent patients were treated only for one session, and others had no remarkable reason. We also could not exclude the possibility that incomplete laser removal of dermal melanocytes situated in the deeper dermis may lead to recurrence when they migrate to more superficial dermis (16). To achieve a more accurate recurrence rate requires more patients and longer term follow-up in the future study.
Related Knowledge Centers
- Birth Defect
- Glaucoma
- Periorbita
- Puberty
- Vertebral Column
- Sclera
- Trigeminal Nerve
- Melanocyte
- Hyperpigmentation
- Mongolian Spot