6. Small non translucent at ant
margin, from lash follicle,
obstructed sebaceous gland.
(cyst of zeis)
Cystic translucent non tender at
ant. lid margin.
(apocrine hydrocystoma,
cyst of Moll)
7. Epidermis implantation into
dermis, 2ry to trauma,
surgery. Firm, nodular SC
containing keratin.
(Epidemal inclusion cyst)
Sequestrated skin during
embryonic development,
typically attached to
periosteum at lateral brow
at suture fusion.
(Dermoid)
8. Tiny, white round papules.
Retention of keratin due to
blockage of pilosebaceous unit.
(Milia)
Lipogranuloma, meibomian cyst.
Rosacea, blepharitis are
association.exclude EOR in
children & malignancy in eldery.
(Chalazion)
Keratin plugs within dilated
orifice of follicles in acne .
Fulgaris. open (backhead),
closed (whitehead)
(Comedones)
11. Proliferation of basal layer of
epithelium with expansion of
squamous epith. Pigmentd ̎ stuck
on ̎ appearance. Shave biopsy é cyo,
laser, chemical peeling can be done.
(Seborrheic keratosis (basal cell
papilloma)
Slowly progressing in sun damaged
skin. Nodular, wart or cutaneous
horn. Low potential of malignancy to
SCC (carcinoma insitu). Excision or
cryo.
(Actinic keratosis)
Insitu = no penetration of
basment membrane of epi
thelium / demis
13. Increase melanin in epidermal
basal layer, increase with sun
exposure.
(Freckle)
Uncommon usually small. Rare
variant is kissing/ split naevus,
may contain numerous hair.
Large one (giant hairy naevus )
has malignant transformation
15%.
(Congenital melanocystic
naevus)
14. Uncommon usually small. Rare
variant is kissing/ split naevus,
may contain numerous hair.
Large one (giant hairy naevus )
has malignant transformation
15%.
(Congenital melanocystic
naevus)
17. Hair bulb proliferation.
Mobile purple hard nodule
with/out calcification.
(Pilomatricoma)
From eccrine sweat gland.
Multiple bilateral papules.
(Syringioma)
18. Unilateral mobile raised bright red
lesion, increase with strain. Blanch.
Involved skin with strawberry
appearance. Systemic association if
multiple?. Resolve at 1y. Ttt with
steroid injection, BB topical &
systemic, surgery.
(Capillary haemangioma)
Congenital malformation of dermal
bl vs. 10% with systemic association
as SWS. Well defined facial pink
patch. Not blanch. Unilateral with 5th
n. Darken with age. Glaucoma
screening. Early ttt with laser.
(Potwine haemangioma)
19. Bl vs, granulation
tissue. Tender
rapidly growing.
Trauma, infection,
surgery, idiopathic.
(Pyogenic
granuloma)
Isolated NF in
normal
individual,
plexiform in NF1,
S-shaped ptosis.
Difficult excision.
(plexiform NF)
Intracellular
lipid. Bil
yellowish SC
plaques, at
medial aspect.
(Xanthelasma)
21. Nodular Ulcerative Sclerosing
• The most common skin malignancy, 90% in
head & neck. The most common lid
malignancy. Locally malignant.
• Inferior, medial, superior, lateral. Medial is
the worst.
• Arise from basal layer of epith.., extend
downward with pallisade arrangemnt of
lobules.
(BCC)
Locally malignant= arise from BM
of epi dermis/thelium. Extend
downward with surrounded
pallisade cell pattern
22. • Fair skin, immunesuppresion, eldery.
• Rapidly growth, with keratinization,
LN.
• Well defined DD: BSC.
• Actinic keratosis, carcinoma in situ
(Bowen), keratoacantoma DD.
(SCC)
Nodular Ulcerative Cutaneous
horn
23. • Rare tumor, from meibomian gland, zeis
gland.
• 5-10% mortality rate.
• More in UL
• Pale foamy vaculated lipid containing
cytoplasm, large hyperchromatic nuclei.
• Nodular (DD chalazion).
• Pagetoid (DD chronic post blepharitis)
(SGC)
Nodular Pegatoid
24. • Fair skin with sun exposure.
• Rapidly growing then regressed over
3m.
• Keratin filled crater.
• Definte ttt is required.
(Keratoacanthoma)
25. • Lentigo maligna (melanoma in situ).
• MM invading dermis.
• Rapidly growing, variable
pigmentation, ill defined, ulceration.
(lentigo maligna & melanoma)
Lentigo
maligna
Nodular
melanoma
MM
30. Merkel cells are for light
touch sensation. Rare
highly malignant
violaceous/ red nodule
with intact skin.
Difficult Dx. Excision ttt.
(Merker cell tumour)
Dermal vascular
malignant tumour, in HIV
& AIDS pt. Associated
systemic dis., bluish or
red in color. Excision,
radiotherapy + ttt cause.
(Kaposi sarcoma)
37. Lid defect surgical protocol
Partial thickness
defect
(direct closure, Z, V/Y
plasty, flap or graft)
Anterior lamellar
Posterior lamellar
defect
Full thickness defect
Small defect < 1/3 lid
( direct closure +/-
canthyolysis )
Moderate 1/3 -1/2 lid
( Tenzel rotational
myocutaneous flap )
Severe > 1/2 lid
( Hughes for LL, Cutler-
Beard bridge for UL )
V Severe
( Mustrade cheek
rotational flap )