Benign Tumors
Ductal Cysts
The round cysts of the glands or Moll are usually located in the angle of the eye. Their contents are clear and watery and can be transilluminated. Gravity can result in ectropion . Therapy consists of marsupialization (=surgical technique). The prognosis is good.
Xanthelasma
Definition: Local fat metabolism disorder that produces lipoprotein deposits. These are usually bilateral in the medial canthus.
Epidemiology: Postmenopausal women are most frequently affected. A higher incidence has also been observed in patients with diabetes, increased levels of plasma lipoprotein, or bile duct disorders.
Symptoms: The soft yellow white plaques are sharply demarcated. They are usually bilateral and distributed symmetrically. Aside from the cosmetic flaw, the patients are asymptomatic.
Treatment and prognosis: The plaques can only be removed surgically. The incidence of recurrence is high.
Molluscum Contagiosum (Dellwarzen)
The noninflammatory contagious infection is caused by Molluscipoxvirus. The disease usually affects children and teenagers and is transmitted by direct contact.
The pinhead-sized lesions have typical central depressions and are scattered near the upper and lower eyelids. These lesions are removed with a curet. (In children this is done under short-acting anesthesia.)
Cutaneous Horn
The yellowish brown cutaneous protrusions consist of keratin. Older patients are more frequently affected. The cutaneous horn should be surgically removed as 25% of keratosis cases can develop into malignant squamous cell carcinomas years later.
Keratoacanthoma
A rapidly growing tumor with a central keratin mass that opens on the skin surface, which can sometimes be expressed. The tumor may resolve spontaneously, forming a small sunken scar. Differential diagnosis should exclude a basal cell carcinoma; the margin of a keratoacanthoma is characteristically avascular. Likewise, a squamous cell carcinoma can only be excluded by a biopsy.
Therapy: Excision
Hemangioma
Definition: Congenital benign vascular anomaly resembling a neoplasm that is most frequently noticed in the skin and subcutaneous tissues.
Epidemiology: Girls are most often affected (approximately 70% ). Facial lesions most commonly occur in the eyelids.
Symptoms: Hemangiomas include capillary or superficial, cavernous, and deep forms.
Diagnostic considerations: Hemangiomas can be compressed, + skin will then appear white.
Differential diagnosis: Nevus flammeus: This is characterized by a sharply demarcated bluish red mark (“port-wine” stain) resulting from vascular expansion under the epidermis (not a growth or tumor).