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Glasses: Hiding or causing skin cancer?

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Summary

Long-term spectacle nose pad use may lead to periocular skin cancer. Chronic pressure can cause malignant transformation, often missed or misdiagnosed, requiring surgical excision and follow-up.

Keywords:
Marjolin ulcerglassesnose pad pressureperiocular skin malignancysquamous cell carcinoma

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Area of Science:

  • Ophthalmology
  • Dermatology
  • Oncology

Background:

  • Periocular skin lesions under spectacle nose pads are often overlooked.
  • Chronic pressure and trauma from spectacles may predispose to malignancy.
  • Early detection of these malignancies can be challenging.

Purpose of the Study:

  • To evaluate malignant transformation of lesions in the periocular skin under spectacle nose pads.
  • To identify clinical and pathological features of these specific malignancies.
  • To propose a mechanism for malignant development in this region.

Main Methods:

  • Retrospective chart review of patients with periocular malignancies near spectacle nose pads.
  • Analysis of clinical features and pathological findings.
  • Study conducted at a tertiary oculoplastic referral center (2007-2013).

Main Results:

  • Ten patients (6 males, mean age 73.5 years) with lesions present for ≥1 year were included.
  • Most common malignancies were squamous cell carcinoma (SCC), intra-epidermal carcinoma (IEC), and basal cell carcinoma (BCC).
  • Lesions were located in the inferior medial canthal area, coinciding with spectacle nose pad placement.

Conclusions:

  • Periocular malignancies under spectacle nose pads can be easily missed or misdiagnosed.
  • Chronic pressure from nose pads may induce immune deficiency, predisposing to malignant transformation (similar to Marjolin ulcers).
  • Complete surgical excision with margin control, follow-up, and contralateral surveillance are crucial for management.