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[Recurrent palpebral keratoacanthoma]

P Cernea¹, C Simionescu

¹Disciplina Oftalmologică Craiova.

Oftalmologia (Bucharest, Romania : 1990)

|January 1, 1997

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A rare keratoacanthoma on the eyelid caused a corneal ulcer in a 74-year-old female. Surgical removal and skin grafting were performed, with ongoing observation for potential recurrence or misdiagnosis.

Area of Science:

Ophthalmology
Dermatology
Pathology

Background:

Keratoacanthoma is a rapidly growing skin tumor.
Eyelid involvement is uncommon but can lead to significant complications.

Observation:

A 74-year-old female presented with a 15-year history of a hyperkeratotic eyelid neoformation.
The lesion extended to the upper eyelid, external canthus, lower eyelid, and palpebral fissure of the right eye.
Previous excision eight years prior resulted in relapse and a corneal ulcer.

Findings:

Surgical extirpation of the eyelid tumor was performed, followed by a free skin graft.
Anatomopathological examination confirmed keratoacanthoma, characterized by acanthosis, hyperkeratosis, and dyskeratosis of the pluristratified epithelium.

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The basal membrane was preserved, with a mild chronic inflammatory infiltrate noted.

Implications:

Accurate diagnosis is crucial, necessitating differentiation from spinocellular epithelioma.
This case highlights the importance of vigilant follow-up for eyelid keratoacanthoma.
Management requires careful surgical planning and consideration of potential complications like corneal ulceration.