eyelid lesions

Question 1

define molluscum contagiosum of the eye

Answer 1

Molluscum contagiosum occurs due to the pox virus, and commonly affect healthy young
children. It is transmitted by direct contact, and patients can autoinnoculate themselves. It can
affect the eyelid and the eyelid margins, which can lead to chronic follicular conjunctivitis and the
eyelid must be examined carefully as these can be easily missed.

Question 2

what do the lesions of molluscum look like ?

Answer 2

They are typically pale, waxy and
umbilicated. Molluscum lesions can spontaneously resolve, but if they cause chronic follicular
conjunctivitis they should be removed by shave excision, cauterisation or cryotherapy.

Question 3

what is chalazion?

Answer 3

Chalazion is a lipogranulomatous inflammation which occurs due to a blocked and inflamed
meibomian gland. It is often seen in association with rosacea and blepharitis.

Question 4

if recurrent chalazion, what should you request?

Answer 4

Recurrent
chalazion maybe a sign of malignancy and therefore should be biopsied. The lesion is usually
firm and nodular, and can cause erythema and discomfort when enlarged

Question 5

rx for chalazion

Answer 5

Treatment comprises
of conservative measures such as hot compress and expression with a cotton bud, or surgical
measures such as incision and curettage. Local steroid injection can also be used though
vascular occlusion is a recognised complication of this.

Question 6

what is the most common periocular cutaneous malignancies?

Answer 6

Basal Cell Carcinoma (BCC) is the most common malignancy in adults, and accounts for
approximately 90% of malignant eyelid tumours. The lower lid is most commonly affected,
followed by the medial canthus, upper lid then the lateral canthal area

Question 7

RF for developing BCC

Answer 7

Risk factors for
developing BCCs include fair skin and UV exposure and it is associated with Gorlin Goltz
Syndrome.

Question 8

appearance of eyelid BCC

Answer 8

r BCC may have pearly nodular appearance with telangiectasia and a rolled edge. BCCs
are locally invasive, rarely metastasizes and are slow growing.

Question 9

mx of periocular BCC

Answer 9

. They are most often managed

with excision and reconstruction.

Question 10

other ca that may occur peri-occular?

Answer 10

Squamous cell carcinoma is much less common than BCCs, and account for approximately 5-
10% of periocular cutaneous malignancies. It is an aggressive malignancy and can metastasise
to the lymph nodes, and cause perineural spread. Other cutaneous malignancies that are less
common include sebaceous cell carcinoma, melanoma and Merkel cell carcinoma.