Lids

Question 1

What is a squamous papilloma?

Answer 1

A benign skin tag - flesh coloured growth made of squamous hyperplasia within the epithelium

Question 2

How can a squamous papilloma be treated?

Answer 2

Excision for cosmesis or effect on vision

Question 3

What is seborrheic keratosis?

Answer 3

Elevated, pigmented, greasy, stuck on plaque
Benign but sudden increase in number or size could indicate systemic malignancy
Develop from intradermal proliferation of basal cells within epidermis
Benign

Question 4

How can seborrheic keratosis be treated?

Answer 4

Complete excision

Question 5

What are epidermal inclusion cysts?

Answer 5

Slowly englarging keratin filled cysts
Benign

Question 6

How can epidermal inclusion cysts be treated?

Answer 6

Excision and curettage

Question 7

What is verruca vulgaris?

Answer 7

AKA viral wart
Epidermal growth caused by HPV
Filiform: project from the skin
Plana: flat
Benign

Question 8

What can verruca vulgaris cause on the eye?

Answer 8

Punctate keratitis
Corneal pannus

Question 9

How can verruca vulgaris be treated?

Answer 9

Often outgrow blood supply and involute (return to original size)
Excision
Cryotherapy
Chemical cautery
Only cosmetic or if eye irritation

Question 10

What is molluscum contagiosum?

Answer 10

1-2mm flesh-coloured papules (often umbilicated centre)
More common in very young and immunocompromised pxs
Spread by skin to skin contact - low transmission rate
Benign

Question 11

How can molluscum contagiosum be treated?

Answer 11

Normally regress spontaneously
If immunocompromised, can develop into disfiguring lesions

Question 12

What is pyogenic granuloma?

Answer 12

Pinkish red, vascularised mass protruding from conjunctiva
Rapid growth, usually a local trauma response
Made of blood vessels and fibroblasts - bleed very easily
Benign

Question 13

What is ephelides?

Answer 13

AKA freckles
1-3mm tan or brown macules in sun exposed areas of skin
Occur more in lighter skin, worsen with sun exposure
No treatment but adv sun protection to minimise appearance
Benign

Question 14

What are sebaceous/pilar cysts?

Answer 14

Blocked pilosebaceous follicles containing sebum
May arise from glands of Zeis, meibomian glands or sebaceous glands assoc with hair follicles
Benign

Question 15

What is actinic keratosis (AK)?

Answer 15

AKA solar keratosis
Pink or red scaly lesion on sun-exposed areas of skin
Pre-malignant - 25% develop into squamous cell carcinoma

Question 16

What is keratoacanthomas?

Answer 16

Rapidly growing papules with keratin filled core
Usually elderly or immunocompromised pxs
Can resolve over a few months but excision recommended due to 12% risk of conversion to squamous cell carcinoma

Question 17

What causes eyelid myokymia (twitching eyelids)?

Answer 17

Stress, fatigue, eyestrain, excessive caffeine consumption

Question 18

How do you confirm a diagnosis of eyelid myokymia?

Answer 18

Episodic
Localised to eyelid
Painless
No functional impairment

Question 19

How do you treat eyelid myokymia?

Answer 19

Rest
Cold compress
Tonic water
Stress reduction
Botox if excessive

Question 20

When should you investigate eyelid myokymia?

Answer 20

Persistent cases