Ligneous conjunctivitis. A clinicopathologic study of 17 cases.

Seventeen cases of ligneous conjunctivitis were studied. Most of the patients were children; however, two elderly individuals were involved (range, birth to 85 years). The most common site was the tarsal conjunctiva, where firm sessile or pedunculated membranous lesions were seen. However, corneal involvement, as well as similar and recurrent lesions, were also present in the larynx, vocal cords, trachea, nose, vagina, cervix, and gingiva. Many recurrences (up to 10 times) rapidly followed simple surgical excision in all patients. Histopathologically, the lesions were characterized by subepithelial, eosinophilic, amorphous material admixed with acute and chronic inflammatory cells. The finding of amorphous material containing fibrin, immunoglobulins, and albumin suggested leakage from hyperpermeable blood vessels. Electron microscopic studies of the lesions disclosed few abnormal blood vessels with wide gaps between endothelial cells that were surrounded by a thick multilaminar basement membrane. The duration of the disease ranged from 4 months to 44 years. After several recurrences, spontaneous resolution occurred in six patients.