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Eyelid skin problems
Text: Miiskin
Introduction
Although the eyelids may be involved with many skin conditions, the most common are listed here.
Skin lesions
Stable painless solitary lesions
- Mole (melanocytic naevus), including congenital melanocytic naevus
- Seborrhoeic keratosis
- Freckles and brown marks
- Chalazion (lipogranulomatous inflammation of the Zeis sebaceous gland at the base of the eyelash, or of the meibomian gland on the inner aspect of the lid; due to occlusion) – a firm, painless swelling
- Salmon patch (angel's kiss)
- Suderiferous cyst (transparent papule containing clear fluid)
- Other types of cyst
- Trichoepithelioma
Stable painless solitary lesions of eyelid
Growing solitary lesions
Skin cancers progressively enlarge.
- Basal cell carcinoma
- Actinic keratoses
- Intraepidermal carcinoma
- Squamous cell carcinoma
- Keratoacanthoma
- Atypical fibroxanthoma
- Sebaceous carcinoma
- Melanoma
Skin cancers of eyelid
Multiple lesions
- Skin tags
- Actinic keratoses
- Xanthelasma palpebrum
- Syringoma
- Cysts
- Milia
- Moniliform blepharosis in lipoid proteinosis (extremely rare)
Eyelid lesions
Infections affecting eyelids
Bacterial skin infections
- External hordeola (stye, infection of the eyelash follicle, usually caused by staphylococcus bacteria )
- Internal hordeola (infection of the meibomian gland)
- Bacterial conjunctivitis
- Preseptal or orbital erysipelas or cellulitis (infections of the tissues around the eye), which is often due to spread from infection in the sinuses (responsible for 60-80% of orbital cellulitis), respiratory tract, impetigo, abscesses, trauma, or insect bites
Eyelid bacterial infection
Viral skin infections
- Viral conjunctivitis
- Herpes simplex (caused by the cold sore virus)
- Herpes zoster ophthalmicus (shingles, caused by the chickenpox virus)
- Viral warts
- Molluscum contagiosum
Eyelid viral infections
Fungal skin infections
Infestation
- Demodex mite infestation of the eyelashes
- Pediculosis pubis (pthiriasis), also called crabs or pubic lice
Eyelid fungal infections
Inflammatory skin conditions affecting eyelids
Dry itchy patches
- Blepharitis
- Atopic dermatitis
- Allergic conjunctivitis and keratoconjunctivitis
- Contact dermatitis, including irritant and allergic contact dermatitis
- Seborrhoeic dermatitis
- Psoriasis
Eyelid dermatitis
Dry non-itchy patches
Dry eyelids
Papules and pustules
Acne vulgaris tends to spare eyelids.
Eyelid papules and pustules
Blisters and erosions
- Stevens Johnson syndrome – toxic epidermal necrolysis
- Cicatricial pemphigoid
- Pemphigus vulgaris
- Erosive lichen planus
Eyelid erosions
Swelling
- Contact dermatitis
- Atopic dermatitis/eczema
- Blepharitis
- Photosensitive contact dermatitis (usually spares the folds and the upper eyelids), including medication-related photosensitization
- Angioedema or urticaria
- Sinusitis
- Conjunctivitis
- Injury including swelling post-surgery or cryotherapy
- Ascher syndrome
Systemic disorders may mimic eyelid disease by causing swelling or redness of the eyelid:
- Dermatomyositis
- Myxoedema
- Thyroid eye disease
- Superior vena cava obstruction
- Sjogren syndrome
- Granulomatosis with polyangiitis
- Churg-Strauss vasculitis
- Amyloidosis
- IgG4-related disease
- Orbital and ocular lymphoid hyperplasia
- Orbital adnexal lymphoma
- Idiopathic orbital inflammatory disease
Eyelid swelling
Dry irritated eyes
- Keratoconjunctivitis sicca
Discolouration
Self-skin examination
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References
- Papier A, Tuttle J, Mahar TJ. Differential Diagnosis of the Swollen Red Eyelid. Am Fam Physician. 2007 15;76(12):1815-1824. PubMed.
- Zug KA, Palay DA, Rock B. Dermatologic Diagnosis and treatment of itchy red eyelids. Surv Ophthalmol. 1996;40:293-306. PubMed.
- Guin JD. Eyelid dermatitis. J Am Acad Dermatol. 2002;47:755-65. PubMed.
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