Eyelid Papilloma

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Background

An eyelid papilloma is any lesion on the eyelid that is papillomatous, that is, of smooth, rounded, or pedunculated elevation.

The lesion that most commonly fits this description is a benign squamous papilloma. However, it is possible that other benign eyelid lesions may take on the same appearance, as well as malignant skin lesions, especially squamous carcinoma. Malignant eyelid skin conditions are covered in other articles; this article outlines benign skin lesions.

Pathophysiology

Squamous papilloma is a benign tumor of epithelial origin.

Epidemiology

Frequency

International

Squamous papilloma is the most common benign lesion of the eyelid.

Race

No known differences in race presentation or frequency exist.

Sex

No difference in occurrence exists between the sexes.

Age

Frequency increases steadily with age, but they may occur at any age and are seen most frequently in patients older than 30 years.

History

In addition to general questions about past medical history and family history, document the following:

Physical

Check the skin for additional lesions, and palpate the preauricular and submaxillary lymph nodes for metastasis if suspecting a malignant lesion.

Causes

No known cause for squamous papilloma exists. However, for most malignant lesions, UV (sun) exposure is the main etiologic factor.

Imaging Studies

Procedures

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.

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]

Surgical Care

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

Further Outpatient Care

Complications

Prognosis

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

Disclosure: Nothing to disclose.

Specialty Editors

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

Disclosure: Nothing to disclose.

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

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

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

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. [View Abstract]
  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. [View Abstract]
  3. Lee BJ, Nelson CC. Intralesional Interferon for Extensive Squamous Papilloma of the Eyelid Margin. Ophthal Plast Reconstr Surg. Jun 8 2011;[View Abstract]
  4. Chopdar A. Carbon-dioxide laser treatment of eye lid lesions. Trans Ophthalmol Soc U K. 1985;104 (Pt 2):176-80. [View Abstract]
  5. Hilovsky JP. Lid lesions suspected of malignancy. J Am Optom Assoc. Aug 1995;66(8):510-5. [View Abstract]
  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. [View Abstract]
  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. [View Abstract]
  8. Kikkawa DO, Ochabski R, Weinreb RN. Ultrasound biomicroscopy of eyelid lesions. Ophthalmologica. Jan-Feb 2003;217(1):20-3. [View Abstract]
  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. [View Abstract]
  10. Margo CE. Eyelid tumors: accuracy of clinical diagnosis. Am J Ophthalmol. Nov 1999;128(5):635-6. [View Abstract]
  11. Rodriguez-Sains RS. Ophthalmologic oncology: common eyelid tumors. J Dermatol Surg Oncol. Apr 1982;8(4):247-53. [View Abstract]
  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. [View Abstract]
  13. Tesluk GC. Eyelid lesions: incidence and comparison of benign and malignant lesions. Ann Ophthalmol. Nov 1985;17(11):704-7. [View Abstract]
  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. [View Abstract]