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Snapshot
  • A 55-year-old man presents with a painless "nodule" on the inner surface of his eyelid. He denies any pain in the area, and it has not affected his vision. Physical examination is notable for a small chalazion. He is recommended to apply warm compresses and lid massages.
Introduction
  • Overview
    • eyelid nodule
  • Epidemiology
    • risk factors
      • blepharitis
      • prior chalazion
  • Pathophysiology
    • obstruction of the eyelid tarsal plate sebaceous gland
      • backed up oily secretions lead to leakage in adjacent tissue, producing a granulomatous inflammatory response
Presentation
  • Symptoms
    • eyelid discomfort or pain in cases of secondary infection 
  • Physical examination
    • nontender nodule in the tarsal plate of the eyelid 
Studies
  • Slit-lamp examination
    • to evaluate the meibomian glands
Differential
  • Sebaceous carcinoma
    • differentiating factors
      • biopsy results demonstrate vacuolated cytoplasm and high mitotic activity
Treatment
  • Conservative
    • symptomatic treatment
      • indication
        • small and asymptomatic chalazions
      • modalities
        • warm compresses
        • lid massage
  • Surgical
    • incision and curettage 
      • indication
        • unresolved chalazion
        • large and symptomatic chalazion
      • comments
        • always send specimen to pathology
Complications
  • Can become secondarily infection
 

 

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(M2.OP.14.14) A 30-year-old woman presents with a bump on her eyelid. She reports that it started as a small lesion that has been progressively increasing in size over several weeks. It is not painful, but she wants to know if it needs to be treated. The patient is generally healthy and smokes marijuana frequently. Physical exam is notable for the finding in Figure A. You instruct the patient to use a hot compress on her eye for several days. After 3 weeks, she returns with persistence of the lesion. Findings on physical exam demonstrate a lack of eyelashes around the lesion. What is the most appropriate next step in the management of this patient?

QID: 104225
FIGURES:
1

Biopsy

5%

(2/41)

2

Cephalexin

20%

(8/41)

3

Excision

22%

(9/41)

4

Observation

44%

(18/41)

5

Warm compresses

5%

(2/41)

M 7 E

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