Summer 2018 | Live Blog | Management of Eyelid Malignancies

Day 2 of the SDPA Summer Conference ended with an illuminating lecture on eyelid malignancies by Dr. Michael Yen, an oculoplastic surgeon. The most common eyelid malignancy is basal cell cancer representing 95% of eyelid malignancies. Suspicious characteristics for eyelid malignancies include growth, lid notching, ulceration, telangiectasias and deepening pigmentation. Madarosis, or loss of eyelashes, is one of the most sensitive characteristics of a skin cancer presentation on the eyelids. Biopsy is absolutely necessary for definitive diagnosis of these lesions.

Next, Dr. Yen discussed the presentation of squamous cell cancers. While SCCs are not common, the concern for these types of lesions is their ability to metastasize as well as the occurrence of perineural invasion. The work up for a SCC involves ruling out local or distant metastasis and are more common in immunocompromised patients and smokers.

Dr. Yen also discussed presentation of sebaceous cell carcinoma, aka the “great masquerader”. Sebaceous carcinomas may have regional or distance metastases. Melanomas represents a very small percentage of eyelid malignancies, though they have the highest mortality rate. When melanomas present at the eyelid margin location, there is a worse prognosis in terms of survival.

Dr. Yen emphasized “it is never too late to start” sun protection. He recommends a hat with a brim for a physical barrier. Additionally, he recommends sunscreen with physical blockers. Dr. Yen does not believe sun glasses to be protective, but can be used in conjunction with a brimmed hat and sunscreen.