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Cards (54)
Mostest
of the grossest
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Eyelid
lesions and
tumours
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E
Kruger
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Glands
In
caruncle
and within
eyebrow
hairs
Sebaceous
gland
Meibomian
gland
Gland
of Zeis
Glands
of Moll
Endocrine
sweat glands
Pilosebaceous
units
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Sebaceous gland
Modified sebaceous glands in
Tarsal
plate
Single row of
20-30
orifices
Synthesize meibum which forms outer layer of
tear film
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Meibomian gland
Modified
sebaceous
glands associated with
lash folicles
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Gland of Zeis
Apocrine
sweat glands
Open into a
lash follicle
or directly into
anterior lid margin
between lashes
More numerous in
lower
lid
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Glands of Moll
Throughout
eyelid
skin
Not confined to
lid margin
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https://www.naturaleyecare.com/eye-conditions/meibomian-dysfunction/meibomian.png
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Self
study
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Kanski pp
39
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Terminology
Clinical
Histological
Classification
Diagnosis
Treatment
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General considerations
Non-neoplastic
lesions
Malignant
lesions
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Non-neoplastic
lesions
Non-cancerous
, non-malignant or
benign
Sterile
vs
infective
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Non-neoplastic lesions
Pathogenesis
Diagnosis
Symptoms
Signs
Treatment
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Chalazion (Meibomian cyst)
Chronic
granulomatous inflammatory
(small area of inflammation) lesion
Meibomian
or
Zeis
glands
Lipid
deposition or
oil
like substance
Surrounded by
lipid-laden
epithelioid cells,
multinucleated
giant cells and lymphocytes
Blepharitis
usually involved
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Malignant lesions
Quality
of tissue looks
irregular
Changes are not
consistent
or
predictable
Neovascular
patterns around and within
Bleeding
and
ulceration
of lesion
Uncharacteristically large
lumps
or
bumps
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15 20
% of periocular skin lesions are
Benign
lesions
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Benign
lesions
Slow
growing
Less
inflamed
Shallow
(not deep and
invasive
)
Well
circumscribed
Usually,
multiple
lesions
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Chalazion
Blockage of
meibomian
glands (orifices) by
sebaceous
secretions
Caused by retention of normal secretions and
granulomatous
tissue formation
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Peanut butter
stye...
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External hordeolum
Infection of
eyelid glands
of Zeiss or Moll
Caused by
Staphylococcus aureus
infection of
sebaceous gland
opening
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Internal hordeolum
Acute
infection of
meibomian
gland
Chalazion
with secondary infection with S
Aureus
More
chronic
More
swollen
than stye as
tarsal
glands are larger
NB! Be cautious of
preseptal
cellulitis
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Other cysts
Cyst of
Zeiss
Cyst of
Moll
Epidermal
inclusion
Epidermoid
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Cyst of Zeiss
Small, non-translucent,
obstruction
of sebaceous gland ass with
eyelash
follicle
Contains
oily
secretions
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Cyst of Moll
Retention
cyst of lid margin
Round, non-tender,
translucent
and
fluid
filled
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Epidermal inclusion
Implantation
of epidermis into dermis following
surgery
Slow growing
, round and
firm
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Epidermoid
Developmental along embryonic lines of
closure
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Epidermal inclusion cyst
Slow growing
Round
and
firm lesion
Common
cutaneous lesions
, often referred to as epidermoid,
epidermal
, inclusion or keratin cysts
Contain keratinized squamous epithelium and
lipids
, which may be odorous if
ruptured
Eyelid lesions
are usually
solitary
, mobile and less than 1 cm
May be
congenital
or may arise from
trauma
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Xanthelasma
Common, bilateral
Affects
middle-aged
and
elderly
individuals
Hyperlipidaemia
in 1/3 of cases
Intracellular
fat
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Pyogenic granuloma
Most common acquired vascular lesion to involve the
eyelids
Fast growing vascularized proliferation of
granulation
tissue
Fast growing, fleshy, red to
pink mass
which readily
bleeds
with minor contact
Usually occurs after
trauma
or
surgery
or it can be idiopathic
Painful
Differential diagnosis includes
Kaposi sarcoma
Treatment can include use of
steroid
to reduce the inflammation or
surgical excision
at the base of the lesion
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Molluscum contagiosum
Common
viral
skin disease caused by a large (double stranded)
DNA pox virus
Infection usually from direct contact in
children
and
sexually
transmitted in adults
Typical lesion appears as a raised,
shiny
, white to pink nodule with a central
umbilication
filled with cheesy material
Lesion is approximately
2mm
to
3mm
in diameter
May occur in
clusters
or groups, particularly in
immunocompromised
individuals
Eyelid
lesions may produce a
follicular conjunctival
reaction
Usually spontaneously resolves
3
to
12
months but may be treated to prevent spread or if the lesion is close to the lid margin
Treatment:
excision
,
cauterization
, cryotherapy, laser
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Verruca Vulgaris
Common cutaneous wart caused by the epidermal infection of the human
papillomavirus
More common in
children
and young
adults
and may occur anywhere on the skin
Lesions appear
elevated
with an irregular, hyperkeratotic papillomatous surface
Lesions along lid margin may cause
papillary conjunctivitis
Tend to be
self limiting
but if treatment required cryotherapy or
surgical excision
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Squamous cell papilloma
Fibrovascular
tissue covered by
hyperkeratotic squamous
epithelium
Common
benign
with range of clinical appearance
Incidence increases with
age
Some cases involve human
papilloma virus
Treatment:
excision
or
cryotherapy
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Seborrheic keratosis /
Basal
cell
papilloma
Slow growing lesion
'stuck on'
appearance
Numerous
Differential diagnosis: pigmented
basal cell carcinoma
, naevus,
melanoma
Treatment:
excision
,
laser ablation
, cryotherapy
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Actinic keratosis
Yellowish rough and crusty lesions that tend to bleed easily
Pre-malignant
: may lead to
squamous cell carcinoma
Cause:
overexposure
to the sun
Similar look to
sebaceous keratosis
but looks more
greasier
that actinic lesions
Treatment: Prompt
excision
=
immediate
referral
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Benign pigmented lesions
Nevus
(Freckle)
Congenital
melanocytic nevus
Intradermal
nevus
Junctional
nevus
Compound
nevus
Strawberry
nevus
Port-wine
stain / Nevus Flammeus
Neurofibroma
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Nevus
(Freckle)
Small
brown
macule (1-5 mm)
Increased
melanin
in the epidermal
basal
layer
Sun-exposed
skin
Can
regress
completely
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Congenital melanocytic nevus
Small
and
uniform
in colour
Kissing
or
split
nevus – upper and lower lid
May contain numerous
hairs
Large
lesions have the potential for
malignancy
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Intradermal nevus
Most
common
Older patients
Papillomatous
lesion with little pigment
Confined to
dermis
with no
malignant
potential
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See all 54 cards
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