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Primary Acquired Melanosis (PAM) is an ocular lesion with pigmentation affecting the conjunctival surface due to embedded melanocytic neoplasms in the epithelial stratum. Protheragen offers comprehensive diagnostics and therapeutics development services for PAM, leveraging cutting-edge technologies and expertise in ocular pathology.
Primary Acquired Melanosis (PAM) emerges as a distinct condition defined by the presence of pigmented patterns on the conjunctiva, which is a part of the eye. PAM is attributed to the premalignant form of the pathology which is capable of evolving into conjunctival melanoma, which resides as one of the critical forms of eye cancer. It is estimated that it most commonly occurs among the white race and during middle age. The condition is further categorized into PAM with or without cellular atypia, where atypical PAM is more likely to undergo malignant change. Approximately 11% of PAM lesions out of all lesions on the conjunctiva represent a significant issue and are of great concern to most medical professionals.
Fig.1 Case of histopathological analysis of PAM. (McGrath L. A., et al., 2023)The biopsy performed on the tissue allows for the verification of some atypical melanocytes as well as cellular atypia. PAM can be differentiated from other benign and malignant melanocytic lesions by immunohistochemistry using HMB45, S-100, or Melan-A.
The development of PAM detection and risk stratification has benefited greatly from progress in molecular diagnostics. Next-generation sequencing (NGS) and targeted gene panels permit the PAM specific mutations like BRAF and TERT promoter mutations to be detected.
Techniques of cytology, like impression cytology, offer a relatively non-invasive means of early screening for PAM. Even though impression cytology cannot completely differentiate between PAM with atypia and Melanoma, it can detect cellular alterations that require further scrutiny.
Topical Chemotherapy
Mitomycin C (MMC) is an example of a topical chemotherapeutic agent which, along with other agents, is helpful in treating PAM with atypia. Proliferative cellular activity is suppressed which in turn helps reduce the chance of recurrence and progression of the disease.
Immunotherapy
Immunotherapy has shown great promise for treating advanced PAM and conjunctival melanoma. PD-1 inhibitors, like nivolumab, have been successfully used in targeting melanoma cells while greatly improving the immune response.
Protheragen seeks to innovate PAM diagnostics and therapeutics with a full spectrum of services. We cover the entire diagnostic and therapeutic continuum, catering to researchers and the pharmaceutical industry, ranging from molecular pathology and histopathological tissue review to custom therapy design and preclinical research.
Protheragen's preclinical research services for PAM encompass in vitro and in vivo models to study disease mechanisms and evaluate novel therapeutics. Our state-of-the-art facilities enable high-throughput screening of drug candidates, genetic profiling of melanocytic lesions, and the development of animal models that recapitulate PAM progression. If you are interested in our services, please feel free to contact us.
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