Eyelid tumors

The palpebral skin is the thinnest in the human body with significant exposure to the sun. This makes the eyelids the prime place to develop benign and cancerous skin lesions. The majority of eyelid lesions are benign and easy to treat by simple excision. The three main lesions are :

• - Basal cell carcinoma, which results from the abnormal proliferation of basal cells in the epidermis
• - Squamous cell carcinoma (squamous cell) which forms from squamous cells (keratinocyte)
• - Melanomas that develop from melanocytes
• - Basal cell carcinoma is the most common skin cancer. It is usually identified very early and its development is slow. For treatment, surgery is very effective

Each year, 65,000 new cases of basal cell carcinoma are diagnosed in France. The increase in the number of cases is related to the increase in life expectancy as well as risky behavior mainly linked to sun exposure. They mostly affect people over 50 and are more common in men than in women.

Some factors are frequently found

• - Intense and repeated exposure to the sun, especially from childhood
• - Often indicative of fair complexion, hair and eyes of so-called sun-sensitive skin
• - Personal history of skin cancer (recurrence)
• - Exposure to ionizing radiation or to certain chemicals such as arsenic, derivatives of petroleum combined with ultraviolet (treatment of psoriasis)
• - Weakened immune system (linked to anti-transplant rejection treatment or a disease such as AIDS)
• - Certain genetic factors

Basal cell carcinoma accounts for 90% of eyelid tumors, it grows slowly and steadily over months and years. It can take on the appearance of a pearly pearl, firm to the touch, often with vascularity and which is likely to break down and ulcerate. A stye alerts us when it becomes chronic, when eyelash loss or if it recurs after simple excision. It can also appear as a scaly and scaly-looking skin plaque. Sometimes it can look like a hardened scar. The appearance of an ulcer or a bleeding lesion should alarm us

Basal cell carcinoma does not spread to remote areas (metastasize), however it continues to grow and infiltrate surrounding tissues.

The positive diagnosis is suspected by the clinic, supported and confirmed by a biopsy and pathological examination.

Basal cell carcinomas can be cured by complete and total excision of the lesion followed by reconstruction to repair the damaged area.

There are several techniques for reconstructing the eyelid, in most cases at the same time as the excision (see photos).

Squamous cell carcinoma is less common but more aggressive. It is characterized by a lesion with a thick, scaly and irregular appearance. But this aspect is not always the rule. Its diagnosis can be made in front of any lesion that does not heal on skin damaged by extensive exposure to the sun.

Squamous cell carcinoma begins as a red area with a scaly, crusted surface. As the tumor grows, it may take shape and harden. Sometimes it looks like a wart. Finally, the cancerous tumor progresses to ulceration and grows in the underlying tissues.

The prognosis for small tumors removed completely and early enough is excellent. Treatment is usually effective and most people survive. The vast majority of squamous cell carcinomas remain in the area where they started, others spread to surrounding tissue, and a few rare cases spread (metastasize) to other areas of the body.

The positive diagnosis is suspected by the clinic, supported and confirmed by a biopsy and pathological examination. Surgery remains the solution, it is done according to strict rules controlled by an anatomopathological report (Mohs microscopy). Radiation therapy may be indicated for advanced cases.

There are several techniques for reconstructing the eyelid, in the majority of cases at the same time as the operation of the excision. As the risk of metastasis exists, doctors closely control the treatment and follow-up.

While melanoma is the least common skin cancer, it is also the most serious. It must be detected at the start of its development for early management.

Contrary to popular belief, just because you have very few moles does not reduce your risk of melanoma. Three-quarters of melanomas are formed outside of a pre-existing mole.

Melanoma is a malignant tumor of melanocytes, the cells that make melanin. significant exposure to the sun promotes the dysregulation of these cells.

Another risk factor is exposure to artificial UV rays from tanning booths. Numerous scientific studies have demonstrated the link between exposure to tanning beds, even once, and the development of melanoma. According to the International Agency for Research on Cancer, the risk of melanoma is increased by 60% for people who have had their first exposure to artificial UV rays before the age of 30.

The rule A B C D, easy to implement, can detect a change in the Asymmetry, Edges, Color, Size or Scalability of a mole.

Melanoma is a dangerous form of skin cancer due to its propensity to spread to other organs (high metastatic potential). Detected early, it heals very well, with a very high survival rate. A good reason to get tested every year!

Since basal cell and squamous cell carcinoma can be caused by sun exposure, it can be prevented with the following measures from early childhood

• - For example, avoid the sun, take the shade, limit outdoor activities between 10 a.m. and 4 p.m. (when the sun's rays are strongest) and avoid sunbathing and using solariums
• - Wear UV-resistant clothing, for example, long-sleeved T-shirts, wide-brimmed pants and hats
• - Apply sunscreen minimum protection having a sun protection factor of 30 with anti Ultraviolet a and anti Ultraviolet b protection, reapplied every 2 hours and after going in water or sweating, but not used to prolong sun exposure