Skin Pathology: Pigmented lesions, neoplasms, immune-mediated lesions, and infections. Lecture 5 Thursday, January 25, 2007 Refs. Basic Pathology Chapter 22 Wheater’s Basic Histopathology Chapter 21 Pathologic Basis of Disease 7th ed Chapter 25.
Skin Pathology:Pigmented lesions, neoplasms, immune-mediated lesions, and infections
Thursday, January 25, 2007
Refs. Basic Pathology Chapter 22
Wheater’s Basic Histopathology Chapter 21
Pathologic Basis of Disease 7th ed Chapter 25
Removing the Mystery of Eyelid Lesion Differential Diagnosis:Beyond Papilloma and Basal Cell Carcinoma
Thomas F. Freddo, O.D., Ph.D., F.A.A.O.
Professor of Ophthalmology, Pathology and Anatomy
Boston University School of Medicine
Adjunct Professor of Optometry
New England College of Optometry
Normal Hyperkeratosis Parakeratosis
Actinic keratosis - the scaly appearance is actually parakeratosis indicating rapid turnover of the epithelium. The basal half of the epithelium looks worrisome, with lateral budding of the rete pegs, but the apical half looks OK. Squamous cell CA-Grade 1/2.
The other major clue to this differential is how long the lesion has been present.
Squamous cell - Central crater dry, filled with brown-yellow, scaly, greasy keratin
Basal Cell - Central crater ulcerated and moist, often with hemorrhage and translucent border
At lid margin, can give rise to follicular conjunctivitis, like mollsucum.