Eyelid Papilloma Workup

  • Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 15, 2012
 

Imaging Studies

  • Ultrasound biomicroscopy (UBM) at 50 MHz has recently been tried in detecting malignancy of various eyelid lesions and has been shown to have a sensitivity of 78-86% and a specificity of 37-69%; that is, UBM can help differentiate between benign eyelid lesions and malignant eyelid lesions.[1]
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Procedures

  • Consideration should be given to photographing the lesion.
  • A biopsy of the lesion may be performed.[2]
  • Accurate diagnosis of an eyelid lesion requires histologic examination.
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Histologic Findings

Usually, squamous papillomas are sessile or pedunculated and have a color similar to the surrounding skin. They often are multiple and tend to involve the lid margin. A small keratin crust often can be palpated on the surface (keratotic papilloma). Microscopically, these lesions are composed of fingerlike projections of vascularized connective tissue covered by hyperplastic epithelium (papillae). The epidermis usually is acanthotic, with elongation of the rete ridges, and shows areas of hyperkeratosis and focal parakeratosis.

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Contributor Information and Disclosures
Author

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS  Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American College of International Physicians, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Mechanical Engineers, American Society of Ophthalmic Plastic and Reconstructive Surgery, Biomedical Engineering Society, Canadian Medical Association, Canadian Ophthalmological Society, Contact Lens Association of Ophthalmologists, International College of Surgeons US Section, Ontario Medical Association, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Brian A Phillpotts, MD  Former Vitreo-Retinal Service Director, Former Program Director, Clinical Assistant Professor, Department of Ophthalmology, Howard University College of Medicine

Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, and National Medical Association

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD  Associate Professor of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Mark T Duffy, MD, PhD  Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic

Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience

Disclosure: Allergan - Botox Cosmetic Honoraria Speaking and teaching

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

  1. 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].

  2. 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].

  3. Lee BJ, Nelson CC. Intralesional Interferon for Extensive Squamous Papilloma of the Eyelid Margin. Ophthal Plast Reconstr Surg. Jun 8 2011;[Medline].

  4. Chopdar A. Carbon-dioxide laser treatment of eye lid lesions. Trans Ophthalmol Soc U K. 1985;104 (Pt 2):176-80. [Medline].

  5. Hilovsky JP. Lid lesions suspected of malignancy. J Am Optom Assoc. Aug 1995;66(8):510-5. [Medline].

  6. 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].

  7. 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].

  8. Kikkawa DO, Ochabski R, Weinreb RN. Ultrasound biomicroscopy of eyelid lesions. Ophthalmologica. Jan-Feb 2003;217(1):20-3. [Medline].

  9. 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].

  10. Margo CE. Eyelid tumors: accuracy of clinical diagnosis. Am J Ophthalmol. Nov 1999;128(5):635-6. [Medline].

  11. Rodriguez-Sains RS. Ophthalmologic oncology: common eyelid tumors. J Dermatol Surg Oncol. Apr 1982;8(4):247-53. [Medline].

  12. 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].

  13. Tesluk GC. Eyelid lesions: incidence and comparison of benign and malignant lesions. Ann Ophthalmol. Nov 1985;17(11):704-7. [Medline].

  14. 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].

 
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