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There are varying degrees of acanthosis and hyperkeratosis. Lenci LT, Kirkpatrick CA, Clark TJ, Maltry AC, Syed NA, Allen RC, Shriver EM. Benign Lesions of the External Periocular Tissues: A Tutorial. Shriver, MD June 14, 2017 Introduction Part of the complete ophthalmic examination includes inspection of the eyelids and lashes.

Chalazion A chalazion is a chronic lipogranulomatous inflammatory process that occurs in the eyelid. Figure 1: Chalazion Presentation Patients will present with a hard, painless nodule in the eyelid that slowly enlarges over the course Fortaz (Ceftazidime)- Multum weeks to months. Figure 2: Chalazion pathology Treatment options Hot compresses Lid hygiene Topical or oral antibiotics Surgical excision Note In contrast to a chalazion, a hordeolum (stye) is an acute, purulent inflammatory process of any gland (meibomian, Ziess, Moll, or eccrine) in the eyelid that presents as a discrete, warm, erythematous, painful pustule over the course of a few days.

Xanthelasma A Xanthelasma is a tumor consisting of intracellular accumulation of lipid. Figure 3: Xanthelasma Presentation The patient will present with multiple soft, yellowish Fortaz (Ceftazidime)- Multum commonly found near the medial canthi of the upper and lower Fortaz (Ceftazidime)- Multum. Pathology The dermis will Fortaz (Ceftazidime)- Multum a collection of histiocytes with foamy, lipid-laden cytoplasm that tend to cluster around blood vessels.

Epidermal inclusion cyst (epidermoid cyst) An epidermal inclusion cyst (EIC) is a dermal implantation cyst of epidermis. Figure 5: Epidermal inclusion cyst Presentation This often presents as a slow-growing, elevated, round, smooth, measure lesion.

Pathology A pathologic specimen of this Fortaz (Ceftazidime)- Multum will show a cystic structure within the dermis that is lined by stratified squamous keratinizing epithelium with desquamated keratin in the cyst lumen. Figure 6: Epidermal inclusion cyst pathology Treatment options Excision Marsupialization Note Milia are multiple, small epidermal inclusion cysts that are histologically identical to EIC and vary only in size.

Apocrine hidrocystoma An apocrine hidrocystoma is a cyst that results from ductal occlusion of an apocrine sweat gland of Moll. Figure 7: Apocrine hidrocystoma Presentation The patient will present with a solitary, round, smooth, cystic lesion located along the lid margin and commonly found near the canthi.

Pathology Pathology shows an irregular Fortaz (Ceftazidime)- Multum structure within the dermis. Figure 8ab: Apocrine hidrocytsoma pathology. Treatment options Marsupialization Excision Note Eccrine hidrocystoma is a ductal retention cyst resulting from Fortaz (Ceftazidime)- Multum of a duct of an eccrine sweat gland. Syringoma A syringoma Fortaz (Ceftazidime)- Multum a benign, adenomatous tumor of the eccrine sweat gland that likely arises from malformed eccrine ducts.

Figure 9: Syringoma Presentation The most common presentation is multiple, soft, small (1-2 mm), mildly hypopigmented Fortaz (Ceftazidime)- Multum arising on or near the lid margin or in the dermis.

Pathology A pathologic sample of this process will show epithelial strands of small basophilic cells extending into the TPOXX (Tecovirimat Capsules)- FDA that represents proliferation of eccrine sweat gland structures.

Figure 10: Syringoma pathology Treatment options Laser ablation Surgical excision Nevus A nevus is Fortaz (Ceftazidime)- Multum congenital, hamartomatous (benign neoplasm in the tissue of origin) tumor of incompletely differentiated melanocytes (nevus cells). Figure 11: Intradermal nevus Presentation The presentation of a nevus is highly variable. Pathology Just as clinical presentation varies, pathologic features vary depending on the evolutionary stage of the nevus.

Figure 12c: Compound nevus pathology Treatment options Shave biopsy Excisional biopsy Wedge resection on the eyelid Seborrheic keratosis A seborrheic keratosis is an acquired, benign papilloma that results from intraepidermal proliferation of benign basal cells. Figure 13: Seborrheic keratosis Presentation The presentation is variable, but lesions are typically sharply defined, brownish and have a rough, warty surface. Pathology Pathologic specimens will show acanthosis, hyperkeratosis, and papillomatosis.

Verruca vulgaris Verruca vulgaris, more commonly Fortaz (Ceftazidime)- Multum as a wart, is a papillomatous growth that roche lilia caused by an epidermal infection with human papilloma virus (usually HPV 6 or 11). Figure 15: Verruca vulgaris Presentation These lesions typically occur near the eyelid margin, but can occur anywhere on the periocular skin. Pathology Verruca lesions are typified by massive papillomatosis with acanthosis.

Figure 16ab: Verruca vulgaris Fortaz (Ceftazidime)- Multum Treatment options Excision Cryotherapy Note Verruca lesions are known for recurrences. Molluscum contagiosum Molluscum contagiosum is an Fortaz (Ceftazidime)- Multum viral infection caused by the DNA poxvirus Molluscum Contagiosum Virus (MCV). Figure 17: Molluscum contagiosum Presentation This process will typically present with multiple, small (1-3 mm), discrete, dome-shaped or nodular, Fortaz (Ceftazidime)- Multum papules with characteristic umbilicated centers.

Pathology This process has a very distinct pathologic appearance of a nodular proliferation of epithelium producing a central Fortaz (Ceftazidime)- Multum of necrotic cells extruding to the surface.

Figure 18ab: Molluscum contagiosum pathology Treatment options Excision Cryotherapy Curettage Note Treatment of the skin Fortaz (Ceftazidime)- Multum will resolve any associated irritative follicular conjunctivitis. Acrochordon An acrochordon is a benign, acquired papilloma. Figure 19: Acrochordon Presentation These lesions can present as single or multiple and can range in size typically from 1 mm to Fortaz (Ceftazidime)- Multum cm.

Pathology Pathologic specimens show a polypoid lesion with a fibrovascular stalk that contains loose, collagenous stroma surrounded by a mostly unremarkable epithelium. Figure 20: Acrochordon pathology Treatment options Excisional Shave biopsy References Barnhill, RL, Crowson, AN.

Textbook of Dermatopathology, 2nd edition. Holds, JB, Chang, WJ, Durairaj, VD, Fortaz (Ceftazidime)- Multum al. Orbits, Eyelids, and Lacrimal System. Basic and Clinical Science Course. Rosa, RH, Buggage, R, Benazepril (Lotensin)- FDA, GJ, et al.

Ophthalmic Pathology and Intraocular Tumors. Yanoff, M, Sassani JW. Ocular Pathology, 6th edition.

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