Eyelid Papilloma Treatment & Management

Updated: Aug 17, 2018
  • Author: Mounir Bashour, MD, PhD, CM, FRCSC, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Treatment

Medical Care

Lee et al studied eyelid margin papillomas for which complete excision was cosmetically unacceptable. The study reported a case in which interferon was an effective treatment for a conjunctival papilloma. [3]

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Surgical Care

Surgical excision usually is a simple procedure for these benign skin lesions.

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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.

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Long-Term Monitoring

Patients should receive follow-up care as needed.

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