Identifying predictive morphologic features of malignancy in eyelid lesions.

Area of Science:

• Ophthalmology
• Dermatology
• Oncology

Background:

• Distinguishing benign from malignant eyelid lesions is challenging for physicians.
• Early and accurate diagnosis is crucial for effective treatment and patient outcomes.

Purpose of the Study:

• To identify key features of eyelid lesions predictive of malignancy.
• To develop a practical triage key for general practitioners to aid in lesion assessment.

Main Methods:

• Prospective observational study involving 199 consecutive periocular lesions.
• Features suggestive of malignancy were identified via surgeon survey.
• Sensitivity, specificity, and odds ratios (ORs) were calculated for identified features.
• A triage key (LUI) was developed based on high-OR features and pilot-tested.

Main Results:

• 19.1% of lesions were malignant.
• Infiltration (OR=18.2), ulceration (OR=14.7), and loss of eyelashes (OR=6.0) were most predictive of malignancy.
• The LUI triage key improved medical students' accuracy in identifying malignant lesions from 46% to 70%.

Conclusions:

• The LUI (loss of eyelashes, ulceration, infiltration) triage key offers an evidence-based, memorable system for physicians.
• This tool assists in the critical triaging of potentially malignant eyelid lesions.