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Dec 2012

A Nodule on the Upper Eyelid—Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD; LORI D. PROK, MD

Arch Dermatol. 2012;148(12):1411. doi:10.1001/archderm.148.12.1411-d

An 80-year-old man presented with a 12-month history of a nonhealing lesion on his upper left eyelid. The lesion had slightly improved with courses of antibiotics but had never fully healed. The patient's medical history was unremarkable except for adenocarcinoma of the prostate, for which he was scheduled to undergo localized radiotherapy. He had a history of considerable UV light exposure but no history of skin cancers.

Physical examination revealed a fixed, indurated, 8-mm nodule on the upper left eyelid, with surrounding erythema and exudate (Figure 1). There was no local or regional lymphadenopathy. A skin swab was sent for microscopy and culture and showed no growth of any organisms. A shave biopsy specimen was obtained for histologic examination and stained with hematoxylin-eosin (Figure 2). A computed tomographic scan of the area was performed to ascertain the extent of the nodule (Figure 3).

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