Lid reconstruction after tumour excision in a patient with seborrhoiec keratosis: a case report

Abstract

Seborrhoiec Keratosis (SK) is one of the most common benign neoplasia of the eyelids, usually affecting elderly females. Typically, the lesions start as discrete, tan-dark brown, flat lesions starting on the face and progressing to other sun-exposed areas. The natural progression is generally an increase in size, thickness and pigmentation of these lesions. A variant of SK, Dermatosis Papulosa Nigra (DPN), has been described in black people, characterized by an earlier and more severe manifestation with multiple, profuse lesions. The diagnosis is clinical, although histopathological examination may be sought to confirm the diagnosis. These lesions are benign and usually only removed for cosmetic reasons. However, in some patients, concern or discomfort may warrant removal. Cryosurgery, electrodesiccation, curettage or shave excision are all effective methods of management. When eyelid lesions are excised, the resulting anterior lamellar defect can be repaired by primary closure, local skin flaps or Full-Thickness Skin Grafts (FTSG). We report a 60 year old female patient who presented with DPN and thick pigmented lesions on the eyelids of both eyes, causing mechanical ptosis, left lower lid ectropion and interfering with vision. She was successfully managed with excision and lid reconstruction for both eyes.