Eyelid skin problems

Author: Dr Emily Ryder, Dermatology Registrar, Hamilton, New Zealand; Chief Editor: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, May 2014.

Categories:

Age site specific, Tumour, Other inflammatory disorder, Eczema or dermatitis

Subcategories:

Benign skin lesions of the eyelid, Malignant skin lesions of the eyelid, Cysts of the eyelid, Infections and infestations of the eyelid, Infalmmatory disorders of the eyelid, Papules of the eyelid, Pustules of the eyelid, Blisters and erosions of the eyelid, Eyelid swelling, Eyelid oedema, Systemic causes of eyelid disorders

ICD-10:

H01.1, H02.6, H00.03, H00.04, H02.84, H02.82, H01.8, H01.9, C44.19, D23.10

ICD-11:

2C36, 2F36.Z, 2F36.4, 2F36.Y, 1E91.1, 9A01, 9A06.Y, 1F00.11, 9A1.4, 1G07.0, 9A06.0, NA00.1Y, NA06.02, 9A02, 9A02.Y, 9A06.7Y

SNOMED CT:

68670009, 93423006, 402193002, 27023008, 36259009, 186544000, 186525007, 403367007, 46210008, 231824001, 231829006, 715266002, 193922006, 89091004, 41446000

miiskin 3 2 133

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Introduction

Although the eyelids may be involved with many skin conditions, the most common are listed here.

Skin lesions

Stable painless solitary lesions

Mole (melanocytic naevus), including congenital melanocytic naevus
Seborrhoeic keratosis
Freckles and brown marks
Chalazion (lipogranulomatous inflammation of the Zeis sebaceous gland at the base of the eyelash, or of the meibomian gland on the inner aspect of the lid; due to occlusion) – a firm, painless swelling
Salmon patch (angel's kiss)
Suderiferous cyst (transparent papule containing clear fluid)
Other types of cyst
Trichoepithelioma

Stable painless solitary lesions of eyelid

Growing solitary lesions

Skin cancers progressively enlarge.

Skin cancers of eyelid

Multiple lesions

Skin tags
Actinic keratoses
Xanthelasma palpebrum
Syringoma
Cysts
Milia
Moniliform blepharosis in lipoid proteinosis (extremely rare)

Eyelid lesions

Infections affecting eyelids

Bacterial skin infections

External hordeola (stye, infection of the eyelash follicle, usually caused by staphylococcus bacteria )
Internal hordeola (infection of the meibomian gland)
Bacterial conjunctivitis
Preseptal or orbital erysipelas or cellulitis (infections of the tissues around the eye), which is often due to spread from infection in the sinuses (responsible for 60-80% of orbital cellulitis), respiratory tract, impetigo, abscesses, trauma, or insect bites

Eyelid bacterial infection

Viral skin infections

Viral conjunctivitis
Herpes simplex (caused by the cold sore virus)
Herpes zoster ophthalmicus (shingles, caused by the chickenpox virus)
Viral warts
Molluscum contagiosum

Eyelid viral infections

Fungal skin infections

Infestation

Demodex mite infestation of the eyelashes
Pediculosis pubis (pthiriasis), also called crabs or pubic lice

Eyelid fungal infections

Inflammatory skin conditions affecting eyelids

Dry itchy patches

Eyelid dermatitis

Dry non-itchy patches

Dry eyelids

Papules and pustules

Acne vulgaris tends to spare eyelids.

Eyelid papules and pustules

Blisters and erosions

Eyelid erosions

Swelling

Contact dermatitis
Atopic dermatitis/eczema
Blepharitis
Photosensitive contact dermatitis (usually spares the folds and the upper eyelids), including medication-related photosensitization
Angioedema or urticaria
Rosacea
Orofacial granulomatosis
Sinusitis
Conjunctivitis
Injury including swelling post-surgery or cryotherapy
Ascher syndrome

Systemic disorders may mimic eyelid disease by causing swelling or redness of the eyelid:

Dermatomyositis
Myxoedema
Thyroid eye disease
Superior vena cava obstruction
Sjogren syndrome
Granulomatosis with polyangiitis
Churg-Strauss vasculitis
Amyloidosis
IgG4-related disease
Orbital and ocular lymphoid hyperplasia
Orbital adnexal lymphoma
Idiopathic orbital inflammatory disease

Eyelid swelling

Dry irritated eyes

Keratoconjunctivitis sicca

Discolouration

Dark circles under the eyes

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Related information

References

Papier A, Tuttle J, Mahar TJ. Differential Diagnosis of the Swollen Red Eyelid. Am Fam Physician. 2007 15;76(12):1815-1824. PubMed.
Zug KA, Palay DA, Rock B. Dermatologic Diagnosis and treatment of itchy red eyelids. Surv Ophthalmol. 1996;40:293-306. PubMed.
Guin JD. Eyelid dermatitis. J Am Acad Dermatol. 2002;47:755-65. PubMed.

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