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JAMA Ophthalmology Clinical Challenge
November 21, 2019

A Black-Pigmented Eyelid Nodule in an African American Woman

Author Affiliations
  • 1Ophthalmology Department, Boston University, Boston, Massachusetts
  • 2Ocular Oncology and Pathology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2020;138(1):99-100. doi:10.1001/jamaophthalmol.2019.4591

A 73-year-old African American woman was referred for the evaluation of a pigmented lesion on her left upper eyelid margin of 6 weeks’ duration. The patient first noted an erythematous, tender swelling with yellow discharge, which later evolved to the pigmented mass. Her ocular history was unremarkable. Her medical history revealed hypertension, type 2 diabetes mellitus, and hyperlipidemia.

On examination, her visual acuity was 20/40 OD and 20/30 OS. There was a sausage-shaped, darkly pigmented (black), focally ulcerated nodule involving the medial upper eyelid margin and measuring 8 × 6 × 4 mm. Associated madarosis, eyelid margin notching, and telangiectasia were noted (Figure 1). The remainder of the anterior segment and a dilated fundus examination were unremarkable.

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