Malignant Lesions

Malignant lesions of the face can appear as bumps, sores, lesions, growths that change in size, shape, and color. They first appear as painless elevated nodules, so it is important to watch for changes. Skin cancer can impact the eyelids, particularly the lower eyelids, or other parts of the face exposed to sun and UV radiation. However, skin cancer can be found anywhere on the eyelids including the upper eyelids, eyelid margins, eyelid corners, and eyebrow skin.

Around the eyelids, eyelashes may be missing and there may be ulcerations, bleeding, and crusting of the skin structure. These are all signs that require further evaluation through a biopsy to confirm a skin cancer diagnosis. Skin cancers can be squamous cell carcinoma, basal cell carcinoma, sebaceous gland carcinoma, and merkel cell carcinoma.

Skin Cancer Facts

Human skin is very vulnerable to ultraviolet-B (UV-B) radiation. Exposure to UV-B results in damaged skin as it becomes red and sunburned. Essentially, the risk of skin cancer grows with every sunburn. Fair-skinned people are more sensitive to UV-B and are nore likely to develop skin cancers than those with darker skin. Eye cataracts are associated with UV exposure. For these reasons, protective clothing, shade, and high SPF sunscreen, sunglasses/contact lenses are imperative.

Common types of skin cancers are basal cell and squamous cell carcinoma. Both types grow but typically do not metastasize to distant parts of the body. Complete excision is recommended, as these carcinomas can eventually invade adjacent areas. Basal and squamous cell carcinoma are usually slow growing, so if they are found early and removed quickly, there is a higher likelihood that surrounding tissue will be unaffected by the carcinoma.

Sebaceous gland carcinoma and malignant melanoma are more dangerous skin cancers as they tend to metastasize. These two types of skin cancer require aggressive and immediate treatment to contain the threat of spreading to other areas.

Treatment

Removal and reconstruction are the pillars of treating malignant lesions. Mohs surgery is a common surgical procedure used for the treatment of skin cancers. The goal is to remove the cancer, minimize recurrence, and preserve as much healthy skin as possible. Depending on the extent of the cancer, reconstructive surgery may then be necessary.

At Idaho Eyelid & Facial Plastic Surgery, our surgeons are specifically trained in reconstructive oculoplastic surgery. We have extensive experience dealing with surgical management of tumors. A variety of these surgeries involve skin grafting and precise stitching. While some patients require a meticulous two-layered closure to ensure the lashes don’t grow in towards the eye as it heals, others may require skin grafting to ensure full closure of the wound. Patients should have realistic expectations about eyelid skin cancer, surgery, recovery, and scarring. A significant effort is always made to minimize scarring and obtain optimal cosmetic results. Follow-up appointments are critical to ensure skin cancer does not recur. Early detection and prompt treatment is imperative.