Regressing conjunctival nevus in a child: a case report
Published in the Journal of Ophthalmic and Vision Research, the authors report a case exhibiting drastic regression of a conjunctival nevus in a child.

A young boy was referred with a pigmented conjunctival lesion in his left eye, for a second opinion, by his primary ophthalmologist. The lesion was first noted by the parents when patient was nine years old. After two months of observation, the lesion remained unchanged in size or color, until his parents were concerned about a complaint of itching in the eye by the patient.

The patient was then referred for consideration of surgical removal of the lesion. There had been no history of trauma or previous surgery. The patient's medical and ophthalmic histories were also unremarkable. On examination, his visual acuity was 20/20 in both eyes. Biomicroscopic examination showed a flat, pigmented, conjunctival lesion at the plica semilunaris, with a variation of brown and intralesional cystic changes, measuring approximately 2.4 x 2.6 mm in the largest basal diameters.

No bleeding or discharge from the lesion or any increase in vascularization was noted. The initial differential diagnosis included conjunctival nevus, C-MIN, or malignant melanoma. The management options of continued observation versus excisional biopsy were discussed with both the patient and parents.

It was decided that the patient would be monitored. Over the following 12 months, the lesion became smaller and by the 15th month, it had almost completely regressed with significant reduction in size and pigmentation. Due to some residual pigmentation at the plica, the patient underwent continued monitoring the patient on a yearly basis.

Key takeaways:-
- This case report illustrates and affirms the potential regression ability of a conjunctival nevus, even if it is situated in an unusual location such as the plica semilunaris.

- In this patient, the pathology of the conjunctival lesion remains unknown due to the lack of histopathological confirmation.

- The disappearance of the lesion observed in this patient could simply be one of the natural courses of a benign conjunctival lesion, albeit a rare one, as majority of these lesions remains stable in size.

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