Benign Eyelid Lesions

Excerpt

Benign eyelid lesions are commonly found during a routine exam by the eye care provider, primary care provider, or dermatologist. The most common benign inflammatory lesions include chalazion and pyogenic granuloma. Infectious lesions include verruca vulgaris, molluscum contagiosum, and hordeolum. Benign neoplastic lesions include squamous cell papilloma, epidermal inclusion cyst, dermoid/epidermoid cyst, acquired melanocytic nevus, seborrheic keratosis, hidrocystoma, cyst of Zeiss, and xanthelasma.

Many less common lesions can mimic the more common ones. All benign lesions need to be differentiated from pre-malignant lesions that include actinic keratosis and keratoacanthoma, as well as malignant lesions that include basal cell carcinoma, squamous cell carcinoma, sebaceous carcinoma, Merkel cell carcinoma, metastatic lesions, cutaneous lymphoma, and melanoma.

A careful history that includes questions regarding predisposing factors, duration, and rate of growth of the lesion, symptoms of tenderness, discharge, or bleeding, combined with careful clinical observation, will determine whether to observe the lesion or refer for a biopsy and histopathological analysis.

When indicated, treatment consists of excision, curettage, electrocautery, cryosurgery, or different types of laser treatments.

Most benign lesions originate from the epidermis, dermis, or adnexal structures of the skin (meibomian glands or glands of Moll and Zeiss). In several studies, about 80 to 85% of eyelid lesions that required biopsy were benign.