Eye Reconstruction For Skin Tags and Bumps
Skin tags can occur in childhood but become more common as one ages. Additionally, they are subject to hormonal changes and pregnant women experience new skin tags. Skin tags are typically an aesthetic concern and do not cause any further problems. However, they may have a relationship to diabetes and obesity so you should have your blood sugar and weight checked by your primary care physician if you notice a sudden onset of many skin tags.
Fortunately, skin tags are simple to remove. Usually these are removed by a doctor using cryosurgery or cautery. Cryosurgery involves applying liquid nitrogen to the surface. This freezes the skin tag. Cautery uses high heat to burn off the skin tag. In both cases the skin tag falls off on its own. In some cases excision is required with the use of a scalpel or special scissors. Control of bleeding and infection is extremely important. Therefore, only a physician should remove skin tags; do not try to do this on your own at home.
Any suspicious bump on or near your eyelid should be examined by a physician. There are a number of warning signs that indicate that the bump may be a skin cancer. These include the “ABCDEs:”
- A: Asymmetry
- B: Borders are irregular
- C: Color variation (more than one color)
- D: Diameter (size is greater than a pencil eraser)
- E: Evolution (anything new – growth, bleeding, itching)
These bumps can be excised by your physician and sent to a laboratory for examination. Remember, not all bumps are cancer. It may be a benign growth, infection or a sign of an underlying condition. Usually removal of the bump can be performed right in the office using a local anesthetic. Other cases require the equipment and safety of an operating room. After the bump is removed, you will likely be asked to apply an antibiotic ointment to prevent infection. Small benign growth that can occur on any part of the body, including the eyelids.
Eye Reconstruction for Cancer
There are four cancers that may be found on the eyelids: basal cell carcinoma, squamous cell carcinoma, melanoma, and sebaceous cell carcinoma. Basal cell carcinoma is the most common eyelid cancer and sun exposure is the largest risk factor.
All suspicious eyelid bumps should be examined by a physician. Signs that indicate that the bump may be cancer is increasing size, changing color, bleeding, scabbing, or crusting.
Your physician will likely take a biopsy of the suspicious bump and send it to a laboratory for examination. If it turns out to be cancer and if not all of it was removed during the biopsy, it will be necessary to go back and excise all of the tissue invaded by the cancer.
Once all the cancer has been meticulously excised, you may need one or more additional procedures to reconstruct the eyelid and restore normal function. In rare cases, it may be necessary to work with other physicians such as dermatologists or oncologists to ensure sufficient and complete treatment.
Could It Be Cancer
Don't Ignore Eyelid Lumps and Bumps
If you have noticed areas around your eyes that have changed in appearance or sensitivity, please consult your doctor immediately or schedule an appointment with Dr. Cockerham’s office. The following information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly.
Patient Education
Basal Cell Carcinoma
Cancerous
Basal Cell Carcinoma
Cancerous
Infiltrative Basal Cell Carcinoma
Cancerous
Medial Canthal Basal Cell Carcinoma
Cancerous
Ulcerative Basal Cell Carcinoma
Cancerous
Umbilicated Basal Cell Carcinoma
Cancerous
Non-pigmented Molevs. Basal Cell Carcinoma
Cancerous
Squamous Cell Carcinoma
Cancerous
Cystic Squamous Cell Carcinoma
Cancerous
Squamous Cell Carcinoma
Cancerous
Eyelid Melanoma
Melanoma
Cancerous
Sebaceous Cell Carcinoma
Sebaceous Cell Carcinoma
Cancerous
Sebaceous Cell Carcinoma
Cancerous
This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly.
Unusual Lesions
Keratoacanthoma
Unusual Lesions
Lentigo Maligna
Unusual Lesions
This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly.
Non-Cancerous
Capillary Hemangioma
Non-Cancerous
Cavernous Hemangioma
Non-Cancerous
Eccrine Cyst
Non-Cancerous
Epithelial Inclusion Cyst
Non-Cancerous
Trichofolliculoma
Non-Cancerous
Apocrine Hidrocystomas
Non-Cancerous
Compound Nevus
Non-Cancerous
Intradermal Nevus
Non-Cancerous
Verruca Vulgaris Papilloma
Non-Cancerous
Papilloma
Non-Cancerous
Seborrheic Keratosis
Non-Cancerous
This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly.
Skin Cancer: By the Numbers
- Skin cancer is the most common form of cancer in the United States.1
- Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.1
- One in five Americans will develop skin cancer in the course of a lifetime.2
- Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two major forms of non-melanoma skin cancer.3
- Between 40 and 50 percent of Americans who live to age 65 will have either skin cancer at least once.
- BCC is the most common form of skin cancer; about one million of the cases diagnosed annually are basal cell carcinomas. 4 BCCs are rarely fatal, but can be highly disfiguring.
- SCC is the second most common form of skin cancer. More than 250,000 cases are diagnosed each year1, resulting in approximately 2,500 deaths.2
Eyelid Oncology
Listen
Ask the right questions
Look
For warning signs
Feel
The region of interest
Classic Risk Factors
- Elderly Caucasian
- Light complexion/blue eyes
- Actinic damage (sun damage)
- Cigarette smoking
American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society; 2009.
Robinson JK. Sun Exposure, Sun Protection, and Vitamin D. JAMA 2005; 294: 1541-43.
“Sun Protection.” National Cancer Institute’s Cancer Trends Progress Report – 2007 Update. 15 April 2008.
“What is Squamous and Basal Cell Skin Cancer?” American Cancer Society. 5 May 2008.
More than 90 % of Non-Melanoma Skin Cancer is Caused by Sun Exposure
- Unprotected exposure
- Outdoors even in the fog
- Tanning booths
- Through car, home or office windows
- Yet only 33% of women and 10% of men wear daily sun block
- Learn More: www.skincancer.org
Risk Factors Specific to Squamous Cell Carcinoma
- HPV 16 and 18 (Human papillomavirus)
- Immunosuppression (weakened immune system)
- HIV – atypical, younger patients
- Organ transplant
- Xeroderma pigmentosum ( a genetic skin disorder)
- Predisposition for epithelial tumors
Incidence Of Skin Cancers in the Young
Incidence:
- Melanoma has tripled
- Squamous cell carcinoma and basal cell carcinoma have doubled
1 in 5 Americans in their 20’s and 30’s will be diagnosed with skin cancer.
Men: are twice as likely as women to be diagnosed with skin cancer.
Skin Cancer Affects Non-Caucasians Too
Melanoma of the skin
Hispanic: birth to death risk
Male: .45 (1 in 221)
Female: .49 (1 in 205)
Skin Cancer MORE deadly for African Americans, Asians & Latinos
Caucasians
1974-1976: 81 %
1995-2001: 92 %
African Americans
1974-1976: 67%
1995-2001: 76%
Melanoma Surveillance, Epidemiology and End Results Program, 1975-2002, National Cancer Institute 2005; American Cancer Society, Surveillance Research, 2006
U.S. Skin Cancer Statistics
- Incidence of has tripled since 1980
- Early detection is crucial !
What to Look for
History: Have you had a prior skin cancer ?
- If history of BCCA -> 50% have second lesion at 5 years
- If history of SCCA -> 75% have second lesion at 5 years
Think beyond the face:
- Women: lower legs
- Men: back
Do you have:
- Pain ? (Usually painless)
- Intermittent scaling or scabbing?
- Irritation when wearing glasses?
Warning Signs
American Cancer Association’s ABCDE
- A – Asymmetry – draw a line down the center
- B – Border irregularity – Uneven, scalloped or notched
- C – Color variations – Brown, tan, black mixed with red, white or blue
- D – Diameter > Larger than a pencil’s eraser
American Cancer Society’s Look for warning signs ABCDE
Evolution = NEW ANYTHING
- Grows or shrinks (suddenly)
- Irritation, redness
- Scaling
- Crusting, oozing or bleeding
- Tenderness or pain
Eyelid Specific Warning Signs
- Telangiectasis (increase of small blood vessels)
- Vessel blanching (whitening of the blood vessels)
- Loss of lashes
- Trichiasis (misdirected eye lashes)
- Hyperpigmentation (increase of pigmentation)
- Hypopigmentation (decrease of pigmentation Sebaceous)
Cell Carcinoma The Worst Offender
- Least common
- 50% misdiagnosed
- Average age: 72 years old
- Women: Men = 2:1
- Ectropion/entropion 10%
- Caruncle 5% (inner corner of the eye)
- Chronic conjunctivitis, cyst or pannus (red, inflamed eye)
Palpation is Important
- Feel the region of interest
- Firm
- Irregular
- Nodular
- Check for lymph nodes
Conclusion
- ABCDE too simplistic > Eyelids have their own special clues
- Suspicious lesions MUST be biopsied > If the answer doesn’t make sense; a second biopsy should be done.
- Wear Sun block
