Lumps And Bumps On Lid

Question 1

Seborrheic keratosis

Answer 1

Benign lesion that is most common in the elderly population. It develops from the intradermal proliferation of basal cells withi nthe epidermis, and classically presents as an elevated, pigmented, crusty, greasy, and/or plaque-like lesion with a “stuck on” appearance

Question 2

Papillomas

Answer 2

“Skin tags”, include viral papilloma and squamous papillomas. Both types may appear as a pedunculated (finger like) or sessile (cauliflower like), and are lobulated with a central vascular core.

Question 3

Squamous papillomas

Answer 3

Common, benign, slow growing squamous epithelial tumors

Question 4

Viral papillomas

Answer 4

HPV and rarely have malignant potential

Question 5

Xanthelasma

Answer 5

Yellow, elevated plaque like lesions that are typically bilateral, symmetric, and located within the medial portion of the epidermis of the eyelids; women are more commonly affected than men

Question 6

Keratoacanthoma

Answer 6

Begins as a small, dome shaped tumor on sun exposed skin (often resembles molluscum in the early stages of development); rapidly progresses to a large lesion (1-2cm) with a central ulceration (resembles SCC). Although it can lead to permanent damage of the eyelid, it often spontaneously shrinks and resolves without treatment

Question 7

Molluscum contagiosum

Answer 7

Shiny, dome-shaped, waxy papules with a central umbilication that are commonly located on the eyelid or the eyelid margin

Question 8

Etiology of molluscum contagiosum

Answer 8

DNA pox virus

Via direct transmission; it is the most common in children and in communities with poor hygiene

Question 9

Etiology of seborrheic keratosis

Answer 9

Unknown; UV light exposure is NOT a contributing factor to its development, as lesions may arise on both sun-exposed and non-exposed areas of the skin

Question 10

Etiology of squamous papillomas and viral papillomas

Answer 10

Squamous hyperplasia within the epithelium, viral papillomas are caused by HPV

Question 11

Etiology of xanthelasma

Answer 11

Older age and higher cholesterol, although patietns with xanthelasma typically have normal cholesterol levels

Question 12

Etiolgoy of keratoacanthoma

Answer 12

Viral origins, enlargement of the lesion is associated with UV light

Question 13

What clinical finding is often associated with molluscum contagiosum

Answer 13

Chronic follicular conjunctivitis
-often develops on the eyelid margins. Spontaneous involutional OT scratching of the lesions can spread the DNA pox virus into the tear film, triggering the development of follicular conjunctivitis, superficial pannus, and keratitis

Question 14

Who is more likely to get molluscum

Answer 14

Children, those in poor hygiene communities, and immunucompromised (HIV)

Question 15

Treatment for molluscum

Answer 15

Incision and Curettage
Shaving excision
Cauterization
Cryotherapy

Question 16

Treatment for seborrheic keratosis

Answer 16

Usually left untreated, unless lesions are irritating to the patient. Shave excision or curettage is recommended for small lesions; complete surgical excision is recommended for larger lesions

Question 17

Treatment for squamous and viral papillomas

Answer 17

May be monitored only or, in the case of larger lesions associated with inflammation, be treated with chemical cauterization, surgical excision, or cryotherapy

Question 18

Treatment for xanthelasma

Answer 18

May be removed through full thickness surgical excision, carbon dioxide laser treatment, and chemical cauterization. Recurrences after treatment are common

Question 19

Treatment for keratoacanthoma

Answer 19

Surgical excision, when necessary

Question 20

Incision and curettage

Answer 20

Surgical method that us often used to remove chalazia: a scalpel is used to make a vertical incision on the inner palpebral surface, and a currette is used to loosen and remove the contents and the chalazion itself