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Eyelid Malignancies

Skin cancer often involves {the} skin of {the} eyelid (most commonly {the} lower eyelid) or adjacent face; however, it could be found anywhere on {the} eyelid margins, corners of {the} eye, eyebrow skin, or adjacent areas of {the} face.

Usually, they appear as painless elevations or nodules. Occasionally, {the} eyelashes are distorted or missing. There could be ulcerations of {the} involved area, along with bleeding, crusting, and/or distortion of {the} normal skin structure. Such findings need to be evaluated and could require a biopsy to confirm {the} diagnosis of skin cancer.

Skin cancer could appear as painless elevations or nodules. Occasionally, {the} eyelashes are distorted or missing. There could be ulcerations of {the} involved area, along with bleeding, crusting, and/or distortion of {the} normal skin structure.

figure2_eyelidcancer

Eyelid Maligancies
Basal Cell Carcinoma Basal Cell Carcinoma
  • Nodular
  • morphea-like
Squamous Cell
Squamous Cell
Sebaceous Gland Carcinoma
Sebaceous Gland Carcinoma Malignant Melanoma Malignant Melanoma

 

Excessive exposure to sunlight is {the} single most important factor associated with skin cancers on {the} face, eyelids, and arms.

 

Skin Cancer Facts

Human skin is particularly affected by {the} sun's UV-B radiation. Exposure to UV-B results in reddening of skin and sunburn.

The risk of skin cancer grows with every sunburn

Fair-skinned individuals develop skin cancers more often than dark-skinned.

Protection via suntan lotion with a high SPF is critical.

Physicians associate eye cataracts with UV exposure. Be sure that you wear sunglasses or contact lenses with appropriate protection.

The most common types of skin cancers are basal cell carcinoma and squamous cell carcinoma. Both types enlarge locally and usually do not spread (metastasize) to distant parts of {the} body. But, if it is not completely excised, it will eventually invade adjacent structures. Since both basal and squamous cell carcinoma are relatively slow growing, if they are detected early and treated in a prompt and appropriate manner, there is an excellent chance of removing {the} tumor completely and minimizing {the} amount of tissue affected by {the} carcinoma.

Sebaceous gland carcinoma and malignant melanoma are more serious forms of skin cancer because they could spread (metastasize) to other parts of {the} body. These types of skin cancer require prompt, aggressive treatment because of {the} threat of early spread.

 

Treatment

There are two very important principles in {the} management of eyelid skin cancers--complete removal and reconstruction. Complete removal of {the} tumor is critical to minimize {the} possibility of recurrence, which is even more difficult to manage.

The surgeon could remove {the} tumor and have a pathologist check {the} tissue margins ("frozen section") to be sure {the} tumor is completely removed. Alternatively, a dermatologic surgeon could excise {the} tumor in a special way ("Mohs technique") to ensure total removal.

Once {the} tumor has been completely removed, reconstructive surgery is usually necessary. Reconstructive surgery is performed to make a new eyelid or repair {the} defect.

Needless to say, {the} goal is to reconstruct {the} eyelid so that it functions well, protects {the} eye, preserves vision, and has a satisfactory cosmetic appearance. The patient must keep in mind that any form of therapy for eyelid skin cancer will leave a scar. However, an effort is always made to minimize scarring and obtain optimal cosmetic results.

After surgery, {the} healing process could take six months to one year. Once {the} wound has healed, follow-up with your physician is necessary to be sure that {the} skin cancer does not recur. Should there be development of a new cancer, it can then be detected early and treated promptly.

 

Terms:

UV Exposure: The intensity of UV radiation reaching {the} Earths surface is not uniform in UV wavelength components. Due to ozone absorption, UV rays with wavelengths shorter than 290nm (often classified as {the} UV-C range) are of negligible intensity.

 

SPF: Sun Protection Factor describes {the} increased allowable time of sun exposure before your particular skin type burns. For example, SPF4 means you are could exposure yourself to {the} sun four times longer without burning.