17 Inflammatory disease of the skin and subcutaneous tissue of the eyelids
Dermatitis-The skin on the eyelid is thin and only loosely attached to the underlying tissues. For these reasons, only low doses of allergen are needed to produce severe changes. Contact dermatitis can be caused by make-up, skin cleansers, hair shampoos and sprays, and anything that might be transferred to the eyelids on fingers. Features include erythema, swelling and scales of the eyelid skin.
Eyelid lumps -These are common and varied. Acute infective lesions have the typical features of infection: pain, swelling, inflammation and purulent discharge. The sterile chalazion is also very common.
Management depends both on the clinical diagnosis and on patient expectation. Many obviously benign lesions such as retention cysts can safely be left alone, but patients often request their removal.
Chalazion-An idiopathic sterile chronic granulomatous inflammation of Meibomian gland usually characterised by painless localised swelling that develops over a period of weeks. Most chalazia point toward the conjunctival surface, which may be slightly reddened or elevated. If sufficiently large, a chalazion may press on the eyeball and cause astigmatism. If its large enough to distort vision or to be a cosmetic blemish, excision is indicated
Erysipelas of the eyelids – (st Anthonys fire) - the skin is normally oedematic, bright red and shiny. It is usually caused by group A haemolytic Streptococcus. Its treated with antibiotics
Molluscum contagiosum- usually very small, shiny and smooth in appearance, flesh-coloured, white, or pink, firm and shaped like a dome with a dent or dimple in the middle and filled with a core of waxy material.
Blepharochalasis- is an inflammation of the eyelid that is characterized by exacerbations and remissions of eyelid edema, which results in a stretching and subsequent atrophy of the eyelid tissue, leading to the formation of redundant folds over the lid margins.
carbuncles and abscesses - A carbuncle is a red, swollen, and painful cluster of boils that are connected to each other under the skin. A boil (or furuncle) is an infection of a hair follicle that has a small collection of pus (called an abscess) under the skin.
A stye or hordeolum is a small, painful lump on the inside or outside of the eyelid. It is an abscess filled with pus and is usually caused by a staphylococcus bacteria eye infection.