Topical Mitomycin-C for Recurrent Pigmented Conjunctival Seborrheic Keratosis: A Case Report

Purpose: We present a clinical experience of using topical mitomycin-C (MMC) 0.02% eye drops for the treatment of recurrent conjunctival seborrheic keratosis following multiple surgical excisions.Case summary: A 79-year-old male presented with a dark-colored conjunctival mass in his right eye, which had developed over 2 months. Notably, the patient reported no history of ocular trauma or familial predisposition to similar conditions. Slit-lamp examination revealed a gelatinous, elevated, dark-brown nodular lesion at the temporal limbus. Surgical excision with cryotherapy was performed, followed by histopathological and immunohistochemical analyses. Histopathological examination of the excised mass confirmed seborrheic keratosis with atypical squamous cells in the basal epithelial layer. Despite initial surgical excision and cryotherapy, the lesion recurred by 16 months postoperatively. A second recurrence occurred 2 months after a second surgical excision, cryotherapy, and amniotic membrane transplantation. A third recurrence was observed 4 months after a surgical excision and cryotherapy. At this stage, topical MMC 0.02% was administered four times daily for 2 weeks without additional surgical intervention. No recurrence or complications were observed during the subsequent 7-month follow-up period.Conclusions: Topical MMC eye drops represent an effective adjunctive therapy for recurrent conjunctival seborrheic keratosis, particularly in the management of the pigmented variant that is resistant to surgical excision and cryotherapy.