History: A healthy 10-year-old boy had a 12 months history of an itchy right eye with frequent tearing. Small masses that gradually developed in the right caruncula lacrimal area and multifocal small nodules with papillomatous growth and vascular fronds.
What’s the diagnosis?
1. Chalazion
2. Papilloma
3. Pterygium
4. Pinguecula
5. Coloboma
Answer: Conjunctival papilloma is an acquired benign epithelial tumor of the conjunctiva and may manifest as a sessile or pedunculated conjunctival mass.
Cause: Human papillomavirus (HPV) 6 and HPV 11
Signs:
- This lesion is typically benign.
- It is seen commonly in older adults.
- Anatomically, the lesion commonly occurs at the limbus or the bulbar conjunctiva.
- These lesions may spread centrally toward the cornea or laterally toward the conjunctiva.
- Visual acuity may be affected if the lesion grows centrally.
- These lesions almost always are unilateral and single.
- They tend to have variable proliferation potential with a tendency to slowly enlarge in size.
Differential diagnosis: Ichthyosis, Sebaceous Gland Carcinoma, Conjunctival Squamous Cell Carcinoma
Treatment: Surgical excision, Erilesional cryotherapy, intralesional or topical interferon-α injection, carbon dioxide (CO2) laser, topical mitomycin-C (MMC), and oral cimetidine have been reported to be adjunctive treatments. Recurrences are not uncommon.