Case Study: August 2012


  • A 60-year-old male presents with an abnormal ocular surface lump at the limbus.
  • This was excised. The main lesion is shown in Fig 1.
  • The background interpalpebral conjunctiva in both eyes demonstrated brown pigmentation. This was also biopsied and shown in Fig 2 (epithlium) and 3 (substantia propria).


  1. What does Fig 1 show?
  2. What do Figs 2 and 3 show?
  3. Which drugs can cause the appearance in Figs 2 and 3?
Click to show answers
  1. In situ squamous carcinoma.
  2. Increased melanin granules in basal cells and melanin granules in substantia propria macrophages (Masson Fontana positive).
  3. Chlorpromazine and epinephrine bitartrate, borate, and hydrochloride (leading specifically to increased melanin granule content). This patient was taking Chlorpromazine tablets..