Which statement best describes a conjunctival nevus?

Which statement best describes a conjunctival nevus?

• A. It is a pigmented lesion with inclusion cysts located within the lesion
• B. It typically first appears around puberty
• C. It is a proliferation of Langerhans cells
• D. It is typically bilateral

Answer: (A)

Conjunctival nevus is a benign pigmented lesion of the conjunctiva, and a defining feature is the presence of epithelial inclusion cysts within the pigmented tissue. These cysts arise when epithelial cells are trapped during nevus formation, so you can often see clear cystic spaces inside the pigmented lesion on examination. This combination of pigmentation with internal cysts is what makes the description of a pigmented lesion with inclusion cysts inside it the best way to characterize a conjunctival nevus.

The other statements don’t fit as well: a proliferation of Langerhans cells points to a different pathology, conjunctival nevi are typically solitary rather than bilateral, and while they can appear in childhood or adolescence, the key diagnostic clue emphasized is the pigmented lesion with inclusion cysts within it.