Conjunctival squamous cell carcinoma: atypical presentation of HIV

Metastatic squamous cell carcinoma (SCC) of the conjunctiva is uncommon in Western countries. A Nigerian patient who presented with right lower lid swelling treated as a chalazion is described here. She re-presented 5 months later with widespread metastatic conjunctival SCC and positive HIV serology. Conjunctival SCC may be difficult to distinguish on clinical appearance alone and in an era of increasing global travel, young patients with a history of high ultraviolet-B radiation exposure and from countries with a high HIV prevalence should be given a low threshold for excision biopsy.