Skin Lesions and Reconstruction

In addition to caring for the health of the eye, our ophthalmologists at Eye Doctors of Washington are trained to examine the area around the eye for any abnormalities of the skin. Skin lesions can be congenital or develop over time, and can vary greatly in appearance depending on the classification. Typically, skin lesions found around the eye area are harmless and their removal is considered primarily an aesthetic concern. However, occasionally these skin lesions are malignant or cancerous. As a result, a board-certified ophthalmologist should inspect any skin abnormality to determine if the lesion is cause for medical concern.

Benign Skin Lesions

Examples of benign or harmless skin lesions include:

Chalazion: A chalazion is a lump on the eyelid caused by oil gland obstruction and inflammation. The lump may increase in size, redden, or become warm or painful.

Stye (Hordeolum): Also called a hordeolum, a stye is caused by oil gland obstruction but is also characterized by an acute infection of the gland. Styes are typically more painful than chalazions.

Skin Tag: Skin tags are acquired growths that are usually flat, flesh-colored protrusions from the skin. Though skin tags are often quite small, they can grow to be the size of a dime or larger. Common skin tag locations include the eyelids, neck, and underarms.

Mole (Nevus): Moles are raised skin lesions that are commonly found on the eyelids and face. They can be pigmented, non-pigmented, or partly flat with areas of raised bumps. Your eye doctor may recommend a biopsy of a mole due to the potential risk of nevi to evolve into dysplastic nevi or melanoma (skin cancer).

Benign nevus before removal

Benign nevus before removal

After removal with radiofrequency

After removal with radiofrequency

Xanthelasma: Xanthelasma are yellow plaques that occur near the corner of the eye. Xanthelasma be an indication of high cholesterol, and can be removed with radiofrequency surgery.

Sweat Gland Cysts (Hydrocystomas): Sweat gland cysts are soft, translucent growths that can arise in isolation or as a group. Frequently found along the inner and outer eyelids, they develop slowly but usually do not resolve without removal.

Epithelial Inclusion Cysts: These cysts are small white-yellow lesions that typically occur on the eyelid, white of the eye, face, or neck. They can develop spontaneously or as a result of trauma or surgery. Like sweat gland cysts, epithelial inclusion cysts will not usually resolve without removal.

Malignant Skin Lesions

Malignant skin lesions are more commonly found around the eyelids and face rather than other areas of the body due to the higher degree of sun-exposure over time. Yearly visits to an ophthalmologist can lead to earlier detection, prompt treatment, and can ultimately require less tissue removal if a malignant skin lesion is discovered. Prompt treatment for malignant skin lesions is particularly important for the area around the eyes since the function of the eyelid is vital to the overall health of the eye.

Basal Cell Carcinoma: Basal cell carcinoma, one of the most common skin cancers found on the eyelid, usually manifests as a slow-growing bump with a color that may only slightly differ from the normal skin. In some cases, the skin may only be slightly raised or even flat. Fortunately, when treated promptly, basal cell carcinoma is often completely curable. Symptoms of basal cell carcinoma include:

  • A skin sore that bleeds easily
  • A sore that does not heal
  • Oozing or crusting spots in a sore
  • Appearance of a scar-like sore without having injured the area
  • Irregular blood vessels in or around the spot
  • A sore with a sunken area in the middle
Lower Lid Basal Cell Carcinoma

Lower Lid Basal Cell Carcinoma

After surgery and reconstruction

After surgery and reconstruction

Squamous Cell Carcinoma: Squamous cell carcinoma, the second most common skin cancer, usually occurs in the upper layer of the skin. Patients with fair skin, light hair, and light eyes have a higher risk of developing squamous cell carcinoma. Other risk factors include:

  • Extensive time outdoors for work or leisure
  • Previous manifestations of basal cell skin cancer
  • Previous skin injuries
  • Long-standing sores
  • Frequent use of tanning beds
Sebaceous Cell Carcinoma

Sebaceous Cell Carcinoma

Full thickness wedge removal of skin cancer and reconstruction

Full thickness wedge removal of skin cancer and reconstruction

Malignant Sebaceous Gland Carcinoma: Sebaceous cell carcinoma is a lesion that may appear benign and most commonly arise in or around the eyes. The most common site of this cancer is the eyelid; however, this abnormal growth can occur on the eye or eyebrow. It is vital to have any abnormality in these areas inspected by a board-certified ophthalmologist since an error or delay in diagnosis is often life threatening if the cancer is permitted to spread.

Schedule a Consultation

If you believe you might have a benign or malignant skin lesion, schedule a consultation for a prompt diagnosis by contacting our office today.

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