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Diagnosing eyelid lesions likened to matching wallpaper
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KOLOA, Hawaii — Most eyelid lesions are benign and 90% can be diagnosed clinically, according to a speaker at the Hawaiian Eye 2017 meeting.
Borrowing a pathologist’s concept, George B. Bartley, MD, said that diagnosing eyelid lesions is like matching wallpaper patterns.
George B. Bartley
Among common clinically identifiable benign lesions “that you’ve all seen in the office” are actinic keratosis, papilloma, cutaneous horn, inclusion cyst, hidrocystoma, syringoma, molluscum contagiosum, milia, intradermal nevi and seborrheic keratosis, Bartley said. However, he cautioned that if there is doubt, then biopsy should be performed.
Regarding epidemiology of malignant eyelid tumors, Bartley said, “Basal cell carcinoma is the culprit about 90% of the time.” Squamous cell carcinoma follows in 8% or 9% of cases, he said.
Roughly half of malignancies are on the lower eyelid, Bartley said, followed by about 25% at the medial canthus, about 12% on the upper eyelid and about 6% to 7% at the lateral canthus or elsewhere.
“We see these clinically in the lower lid. The sun beats down and reflects in that concave mirror at the medial canthus and that’s where bad things happen,” he said. – by Patricia Nale, ELS
Reference:
Bartley GB. Diagnosis and management of eyelid lesions. Presented at: Hawaiian Eye; Jan. 14-20, 2017; Koloa, Hawaii.
Disclosure: Bartley reports no relevant financial disclosures.