Differential Diagnosis for Grey Spot on Conjunctiva in a 4-year-old with History of Mongolian Spot
- Single most likely diagnosis
- Conjunctival melanosis: This condition is characterized by benign pigmentation of the conjunctiva, which could be related to the patient's history of Mongolian spot, a congenital melanocytic lesion. The grey spot on the conjunctiva could be a manifestation of this condition.
- Other Likely diagnoses
- Conjunctival nevus: A benign growth on the conjunctiva that can appear as a grey spot. Given the patient's age and history of Mongolian spot, it's plausible that the grey spot could be a nevus.
- Foreign body: A small foreign object, such as a piece of dust or an eyelash, could be lodged in the conjunctiva, causing a grey appearance.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Malignant melanoma: Although rare in children, conjunctival melanoma can present as a pigmented lesion. Early detection is crucial for treatment and prognosis.
- Kaposi's sarcoma: A rare, malignant tumor that can affect the conjunctiva, especially in immunocompromised individuals. It's essential to consider this diagnosis, especially if the patient has a history of immunodeficiency.
- Rare diagnoses
- Conjunctival amyloidosis: A rare condition characterized by the deposition of amyloid protein in the conjunctiva, which can cause a greyish appearance.
- Primary acquired melanosis: A rare, potentially precancerous condition that can present as a grey or pigmented lesion on the conjunctiva.