What is the cause of this woman’s periocular lesion?


David L. Kaplan, MD—Series Editor

This 58-year-old woman presented for evaluation of an asymptomatic lesion around her eyelid.

What is the cause of this woman’s periocular lesion?

  1. Seborrheic keratosis
  2. Milium
  3. Sebaceous hyperplasia
  4. Actinic keratosis
  5. Basal cell carcinoma

Answer on next page

Answer: Seborrheic keratosis

The eyelids are an important region to examine that often is overlooked, since many older patients wear corrective eyewear that they do not remove during the physical examination. The eyelid area is more prone to sun-induced changes due to inadequate sun protection. Studies have identified the eyelids as a high-risk area for inadequate sunscreen application, given that most people do not want to get sunscreen in their eyes. In addition, most sunglasses do not filter out the UV rays that can damage the skin from the sides of the glasses.

It is important to remind patients about sunscreen application in these periocular areas where skin cancers can develop and have a major effect on the quality of life because of the anatomic location.

Chemical-free sunscreens containing titanium dioxide and/or zinc oxide generally will be best tolerated. Hopefully, your patients will see eye-to-eye with you about your recommendations.