Eyelid Oncology
Eyelid Lumps and Bumps - could it be cancer?
This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer
Eyelid Melanoma |
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Melanoma
 Cancerous
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This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer
Unusual Lesions
Keratoacanthoma |
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Keratoacanthoma
Unusual Lesions |
Lentigo Maligna |
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Lentigo Maligna
Unusual Lesions |
This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer
Non-Cancerous
Trichofolliculoma |
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Trichofolliculoma
Non-Cancerous |
Apocrine Hidrocystomas |
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Apocrine Hidrocystomas
Non-Cancerous |
Compound Nevus |
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Compound Nevus
Non-Cancerous |
Intradermal Nevus |
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Intradermal Nevus
Non-Cancerous |
Seborrheic Keratosis |
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Seborrheic Keratosis
Non-Cancerous |
This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer
Skin Cancer: By the Numbers
- Skin cancer is the most common form of cancer in the United States.1
- Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.1
- One in five Americans will develop skin cancer in the course of a lifetime. 2
- Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two major forms of non-melanoma skin cancer.
3
- Between 40 and 50 percent of Americans who live to age 65 will have either skin cancer at least once.
- BCC is the most common form of skin cancer; about one million of the cases diagnosed annually are basal cell carcinomas. 4 BCCs are rarely fatal, but can be highly disfiguring.
- SCC is the second most common form of skin cancer. More than 250,000 cases are diagnosed each year1, resulting in approximately 2,500 deaths.2
Eyelid Oncology
Listen
Ask the right questions
Look
For warning signs
Feel
The region of interest |
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Classic Risk Factors
- Elderly caucasian
- Light complexion/blue eyes
- Actinic damage (sun damage)
- Cigarette smoking
American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society; 2009.
Robinson JK. Sun Exposure, Sun Protection, and Vitamin D. JAMA 2005; 294: 1541-43.
"Sun Protection." National Cancer Institute's Cancer Trends Progress Report - 2007 Update. 15 April 2008. Link.
"What is Squamous and Basal Cell Skin Cancer?" American Cancer Society. 5 May 2008. Link.
More than 90 % of Non-Melanoma Skin Cancer is Caused by Sun Exposure
- Unprotected exposure
- Outdoors even in the fog
- Tanning booths
- Through car, home or office windows
- Yet only 33% of women and 10% of men wear daily sun block
- Learn More: www.skincancer.org
Risk Factors Specific to Squamous Cell Carcinoma
- HPV 16 and 18 (Human papilloma virus)
- Immunosuppression (weakened immune system)
- HIV – atypical, younger patients
- Organ transplant
- Xeroderma pigmentosum ( a genetic skin disorder)
- Predisposition for epithelial tumors
Incidence Of Skin Cancers in the Young
Incidence:
- Melanoma has tripled
- Squamous cell carcinoma and basal cell carcinoma have doubled
1 in 5 Americans in their 20's and 30's will be diagnosed with skin cancer.
Men: are twice as likely as women to be diagnosed with skin cancer.
Skin Cancer Affects Non-Caucasians Too
Melanoma of the skin
Hispanic: birth to death risk
Male: .45 (1 in 221)
Female: .49 (1 in 205)
Skin Cancer MORE deadly for African Americans, Asians & Latinos
Caucasians
1974-1976: 81 %
1995-2001: 92 %
African Americans
1974-1976: 67%
1995-2001: 76%
Melanoma Surveillance, Epidemiology and End Results Program, 1975-2002, National Cancer Institute 2005; American Cancer Society, Surveillance Research, 2006
U.S. Skin Cancer Statistics
- Incidence of has tripled since 1980
- Early detection is crucial !
What to Look for
History: Have you had a prior skin cancer ?
- If history of BCCA -> 50% have second lesion at 5 years
- If history of SCCA -> 75% have second lesion at 5 years
Think beyond the face:
- Women: lower legs
- Men: back
Do you have:
- Pain ? (Usually painless)
- Intermittent scaling or scabbing?
- Irritation when wearing glasses?
Waring Signs:
American Cancer Association’s ABCDE
| A |
Asymmetry - draw a line down the center |
| B |
Border irregularity - Uneven, scalloped or notched |
| C |
Color variations - Brown, tan, black mixed with red, white or blue |
| D |
Diameter > Larger than a pencil’s eraser |
American Cancer Society’s Look for warning signs ABCDE
Evolution = NEW ANYTHING
- Grows or shrinks (suddenly)
- Irritation, redness
- Scaling
- Crusting, oozing or bleeding
- Tenderness or pain
Eyelid Specific Warning Signs
- Telangiectasis (increase of small blood vessels)
- Vessel blanching (whitening of the blood vessels)Loss of lashes
- Trichiasis (misdirected eye lashes) Hyperpigmentation (increase of pigmentation) Hypopigmentation (decrease of pigmentation Sebaceous)
Cell Carcinoma The Worst Offender
- Least common
- 50% misdiagnosed
- Average age: 72 years old
- Women: Men = 2:1
- Ectropion/entropion 10%
- Caruncle 5% (inner corner of the eye)
- Chronic conjunctivitis, cyst or pannus (red, inflamed eye)
Palpation is Important
- Feel the region of interest
- Firm
- Irregular
- Nodular
- Check for lymph nodes
| Sebaceous cell carcinoma |
Melanoma |
Preauricular, (in front of ear) or cervical nodes 4%
Lung
Bone
Brain |
Regional lymph nodes
Liver
Brain
Bone |
Biopsy Options
- Punch biopsy
- Pentagonal wedge
- Conjunctival mapping
- Mohs
- Skin Only – beware of what lies at the base of a cutaneous horn
SCCA Treatment
Surgical resection: 2-3 mm margins
Conclusion
| ABCDE too simplistic |
Eyelids have their own special clues |
| Suspicious lesions MUST be biopsed |
If the answer doesn’t make sense; a second biopsy should be done. |
| Wear Sun block |
