Skin cancer often involves the skin of the eyelid or
adjacent areas of the face. Eyelid skin cancers occur
most often in the lower eyelid, but may be found
anywhere on the eyelid margins, corners of the eye,
eyebrow skin, or adjacent areas of the face.
they appear as painless elevations or nodules. Occasionally
the eyelashes are distorted
or missing. There may be ulcerations of the involved
area, along with bleeding crusting, and/or distortion
of the normal skin structure. Such findings need
to be evaluated and may require a biopsy to confirm
the diagnosis of the cancer.
Excessive exposure to sunlight is the single most
important factor associated with skin cancers on
the face, eyelids, and arms. Fair-skinned people
develop skin cancers far more frequently than dark-skinned
people. Skin cancers may also be hereditary.
The most common types of skin cancers are basal
cell carcinoma and squamous cell carcinoma. Both
types occur locally and usually do not spread (metastasize)
to distant parts of the body. However, with time,
if not completely removed, either type will invade
It is important to know that
basal and squamous cell carcinomas are relatively
Thus, when detected early and treated in a prompt
and appropriate manner, there is a better chance
of removing the tumor completely and minimizing
the amount of tissue affected by the carcinoma.
gland carcinoma and malignant melonoma are more
serious forms of skin cancer because
they may spread (metastasize) to other parts
of the body. These types of skin cancer require
prompt, aggressive treatment because of the threat
of early spread.
There are two very important principles in the
management of eyelid skin cancer, complete removal
Complete removal of the tumor
is critical to minimize the possibility of recurrence,
which is even more difficult to manage. The
surgeon may remove the tumor and have a pathologist
check the tissue margins ("frozen section")
to be sure the tumor is completely removed.
In another method a surgeon excises the tumor
in a special way ("Mohs tecnique")
to ensure total removal.
Once the tumor has
been completely removed, reconstructive surgery
is usually necessary.
Occasionally, the wound can heal on its own
through a process called "granulation".
More commonly, reconstruction surgery is performed
to make a new eyelid or repair the defect.
excellent techniques are available to reconstruct
almost any surgical defect. The
operation will be specifically tailored to
the defect that is present following removal
of the tumor. Regardless of technique, the
goals remain the same: to reconstruct the eyelid
so that it functions properly, protects the
eye, preserves vision, and has a satisfactory
Any form of therapy for
eyelid skin cancer will leave a scar. However,
an effort is always
made to minimize scarring and obtain optimal
cosmetic results. After surgery, the healing
process may take six months to one year. Once
the wound has healed, follow-up with your physician
is necessary to be sure that the skin cancer
does not recur. Should there be development
of a new cancer, it can then be detected early
and treated promptly.