Eyelid Lesions

Question 1

what are 2 benign conditions?

Answer 1

hordeolum and chalazion

Question 2

what is a hordeolum?

Answer 2

acutely presenting, erythematous tender bump within the eyelid

Question 3

what is an external hordeolum?

Answer 3

infection of the glands of Zeiss/Moll or eyelash follicle

Question 4

what is an internal hordeolum?

Answer 4

infection of meibomian glands

Question 5

what is the treatment for a hordeolum?

Answer 5

reassure patient they are self-limiting and resolve in 1-2 weeks = warm compress and if needed topical antibiotic ointment (incision/drainage)

Question 6

what is a chalazion?

Answer 6

lipogranulomatous inflammation, chronic, rubbery, painless localized swelling of eyelid

Question 7

what is an external chalazion?

Answer 7

inflammation of Zeiss/Moll glands

Question 8

what is an internal chalazion?

Answer 8

inflammation of meibomian glands

Question 9

what is the treatment for a chalazion?

Answer 9

reassure patient most clear in weeks to months = warm compress or surgical incision/drainage or steroid injection

Question 10

what is the definition of malignant?

Answer 10

it grows and invades adjacent tissues

Question 11

what is the definition of metastatic?

Answer 11

infiltrates the blood vessels and lymphatic’s to spread throughout the body

Question 12

where is the most prominent area of eyelid skin cancers? Where is the least likely?

Answer 12

44% = lower eyelid
19% = medial canthus
17% = eyebrow
16% = upper eyelid
4% = lateral canthus

Question 13

what type of skin cancer is highly malignant and potentially lethal?

Answer 13

sebaceous cell carcinoma

Question 14

where does a sebaceous cell carcinoma originate from?

Answer 14

meibomian glands of tarsal plate and glands of Zeiss

Question 15

who usually gets a sebaceous cell carcinoma?

Answer 15

middle-aged or elderly patients

Question 16

what type of carcinoma represents 90% or more of malignant eyelid tumors?

Answer 16

Basal cell carcinomas

Question 17

what are the signs of a basal cell carcinoma?

Answer 17

small, slow-growing, firm, painless, raised, pearly nodule, telangiectasia (spider veins) and indurated (hardened)

Question 18

what are the signs of a squamous cell carcinoma?

Answer 18

variable presentation - similar to BCC, flat plaque with everted edges, surface crusting, no surface telangiectasia (spider veins)

Question 19

what type of carcinoma is faster growing and more likely to metastasize and recur locally?

Answer 19

squamous cell carcinoma

Question 20

which type of eyelid lesion is the leading cause of death from all primary skin malignancies?

Answer 20

melanoma

Question 21

what are the signs of a melanoma?

Answer 21

pigmented thickening of eyelid or extension of pigment from conjunctiva, variably pigmented, can change color, bleed or grow

Question 22

what are the ABCDE signs you should watch for?

Answer 22

asymmetry, border, color, diameter, elevation/evolution