An eyelid papilloma is any lesion on the eyelid that is papillomatous, that is, of smooth, rounded, or pedunculated elevation.
The lesion that most commonly fits this description is a benign squamous papilloma. However, it is possible that other benign eyelid lesions may take on the same appearance, as well as malignant skin lesions, especially squamous carcinoma. Malignant eyelid skin conditions are covered in other articles; this article outlines benign skin lesions.
Squamous papilloma is a benign tumor of epithelial origin.
Squamous papilloma is the most common benign lesion of the eyelid.
No known differences in race presentation or frequency exist.
No difference in occurrence exists between the sexes.
Frequency increases steadily with age, but they may occur at any age and are seen most frequently in patients older than 30 years.
In addition to general questions about past medical history and family history, document the following:
Check the skin for additional lesions, and palpate the preauricular and submaxillary lymph nodes for metastasis if suspecting a malignant lesion.
No known cause for squamous papilloma exists. However, for most malignant lesions, UV (sun) exposure is the main etiologic factor.
Usually, squamous papillomas are sessile or pedunculated and have a color similar to the surrounding skin. They often are multiple and tend to involve the lid margin. A small keratin crust often can be palpated on the surface (keratotic papilloma). Microscopically, these lesions are composed of fingerlike projections of vascularized connective tissue covered by hyperplastic epithelium (papillae). The epidermis usually is acanthotic, with elongation of the rete ridges, and shows areas of hyperkeratosis and focal parakeratosis.
Lee et al studied eyelid margin papillomas for which complete excision was cosmetically unacceptable. The study reported a case in which interferon was an effective treatment for a conjunctival papilloma.
Surgical excision usually is a simple procedure for these benign skin lesions.