Eyelid skin problems — extra information
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Introduction
Skin lesions
Infections
Inflammatory skin conditions affecting eyelids
Discolouration
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
Growing solitary lesions
Skin cancers progressively enlarge.
- Basal cell carcinoma
- Actinic keratoses
- Intraepidermal carcinoma
- Squamous cell carcinoma
- Keratoacanthoma
- Atypical fibroxanthoma
- Sebaceous carcinoma
- Melanoma
Multiple lesions
- Skin tags
- Actinic keratoses
- Xanthelasma palpebrum
- Syringoma
- Cysts
- Milia
- Moniliform blepharosis in lipoid proteinosis (extremely rare)
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
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
Fungal skin infections
Infestation
- Demodex mite infestation of the eyelashes
- Pediculosis pubis (pthiriasis), also called crabs or pubic lice
Inflammatory skin conditions affecting eyelids
Dry itchy patches
- Blepharitis
- Atopic dermatitis
- Allergic conjunctivitis and keratoconjunctivitis
- Contact dermatitis, including irritant and allergic contact dermatitis
- Seborrhoeic dermatitis
- Psoriasis
Dry non-itchy patches
Papules and pustules
Acne vulgaris tends to spare eyelids.
Blisters and erosions
- Stevens Johnson syndrome – toxic epidermal necrolysis
- Cicatricial pemphigoid
- Pemphigus vulgaris
- Erosive lichen planus
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
Dry irritated eyes
- Keratoconjunctivitis sicca
Discolouration
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.
Books about skin diseases
Text: Miiskin
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