Eyelid Papilloma Follow-up
- Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS; Chief Editor: Hampton Roy Sr, MD more...
Further Outpatient Care
- Patients should receive follow-up care as needed.
Complications
- Surgical scarring and possibly lid notching are the only likely complications. Usually, the lesions are so small that bleeding and infection rarely occur postexcision.
- Premalignant, malignant, or benign eyelid skin lesions may be papillomatous.
- Cysts - Epidermal inclusion, sudoriferous, sebaceous
- Seborrheic keratosis usually occurs in middle-aged or elderly patients and appears as brown-black, "stuck on," well-circumscribed, crustlike lesions. Usually, the lesions are slightly elevated and uninflamed. The lesions can be removed with a shave biopsy, if desired. In black adults, a heavily pigmented variant, dermatosis papulosa nigra, occurs involving the malar region and often the eyelids.
- Keratoacanthoma appears similar to basal cell carcinoma and squamous cell carcinoma because it is elevated with a central ulcer crater. However, these dome-shaped tumors with rolled margins usually appear and rapidly grow in size (up to 1-2 cm) over a few weeks to months and then often spontaneously involute. The tumors can be destructive, especially if they involve the eyelash margin. To be sure of the diagnosis, surgical excision and biopsy often is performed. These tumors can occur in individuals who are immunosuppressed (eg, after renal transplantation).
- Nevus is usually light to dark brown, but it can be amelanotic and indistinguishable from a squamous papilloma. Usually, it is well circumscribed, sometimes with hair growing from its surface. It does not grow in size.
- Inverted follicular keratosis usually presents as a solitary nodular or wartlike keratotic mass, it may be pigmented simulating a melanocytic lesion. It also can present as a cutaneous horn. If incompletely excised, it has a tendency to recur.
- Pseudoepitheliomatous hyperplasia often clinically and histopathologically is confused with carcinoma. Usually, it is elevated with an irregular, ulcerated, or crusted surface, mimicking squamous cell carcinoma or basal cell carcinoma. It can occur anywhere on the eyelid and usually is of short duration (weeks to months). They may be associated with mycotic infections, insect bites, drugs, burns, radiation therapy, and underlying malignant lymphoma.
Prognosis
- Prognosis is excellent. However, the lesions can recur in the same or different location.
Patient Education
- Warn patients to protect their skin from the sun's damaging influence, with hats, sunglasses, and protective lotions, and to minimize exposure to the sun. See a medical practitioner if any new lesions appear.
Bajaj MS, Aalok L, Gupta V, Sen S, Pushker N, Chandra M. Ultrasound biomicroscopic appearances of eyelid lesions at 50 MHz. J Clin Ultrasound. Oct 2007;35(8):424-9. [Medline].
Eshraghi B, Torabi HR, Kasaie A, Rajabi MT. The use of a radiofrequency unit for excisional biopsy of eyelid papillomas. Ophthal Plast Reconstr Surg. Nov-Dec 2010;26(6):448-9. [Medline].
Lee BJ, Nelson CC. Intralesional Interferon for Extensive Squamous Papilloma of the Eyelid Margin. Ophthal Plast Reconstr Surg. Jun 8 2011;[Medline].
Chopdar A. Carbon-dioxide laser treatment of eye lid lesions. Trans Ophthalmol Soc U K. 1985;104 (Pt 2):176-80. [Medline].
Hilovsky JP. Lid lesions suspected of malignancy. J Am Optom Assoc. Aug 1995;66(8):510-5. [Medline].
Kersten RC, Ewing-Chow D, Kulwin DR, Gallon M. Accuracy of clinical diagnosis of cutaneous eyelid lesions. Ophthalmology. Mar 1997;104(3):479-84. [Medline].
Khong JJ, Leibovitch I, Selva D, Dodd T, Muecke J. Sebaceous gland carcinoma of the eyelid presenting as a conjunctival papilloma. Clin Experiment Ophthalmol. Apr 2005;33(2):197-8. [Medline].
Kikkawa DO, Ochabski R, Weinreb RN. Ultrasound biomicroscopy of eyelid lesions. Ophthalmologica. Jan-Feb 2003;217(1):20-3. [Medline].
Korn EL. Use of the carbon dioxide laser for removal of lesions adjacent to the punctum. Ann Ophthalmol. Jun 1990;22(6):230-4. [Medline].
Margo CE. Eyelid tumors: accuracy of clinical diagnosis. Am J Ophthalmol. Nov 1999;128(5):635-6. [Medline].
Rodriguez-Sains RS. Ophthalmologic oncology: common eyelid tumors. J Dermatol Surg Oncol. Apr 1982;8(4):247-53. [Medline].
Rumelt S, Pe'er J, Rubin PA. The clinicopathological spectrum of benign peripunctal tumours. Graefes Arch Clin Exp Ophthalmol. Feb 2005;243(2):113-9. [Medline].
Tesluk GC. Eyelid lesions: incidence and comparison of benign and malignant lesions. Ann Ophthalmol. Nov 1985;17(11):704-7. [Medline].
Wohlrab TM, Rohrbach JM, Erb C, Schlote T, Knorr M, Thiel HJ. Argon laser therapy of benign tumors of the eyelid. Am J Ophthalmol. May 1998;125(5):693-7. [Medline].

