Eyelid tumours

I work very closely with my dermatology colleagues especially when it comes to managing periocular skin cancers.

Basal Cell Carcinomas (BCC) are the most common skin cancers of the eyelid, cheek and forehead skin. The second most common skin cancer is a Squamous Cell Cancer (SCC) and there are other less frequently occurring skin cancers that do appear in this area too.

Basal Cell Carcinomas are skin cancers, that locally invade the skin and surrounding structures. They can be slow growing or more aggressive types of BCCs. They appear as small ulcers, red/ sore patches, nodules or elevated areas on the skin that slowly enlarge in size over months. They may not have any symptoms initially, but later they may bleed, itch weep or crust.

A Squamous Cell Carcinoma is the more aggressive of the two most common skin cancers. The appearance is that of a scally red patch, open sore, warty lesion or a raised grow with a central depression. Sometimes these lesions can also crust over, itch or bleed. SCCs if left untreated can invade the deeper structures and are also able to spread to other parts of the body.

The best and most effective treatment of these skin cancers is surgical excision of the tumour. There are other modalities available, but they are not as effective in the periocular region.

Once the diagnosis of a skin cancer is confirmed by a biopsy that I can do in the clinic, I refer my patients to my dermatology colleagues who can offer Mohs micrographic surgery. A method of removal of the skin cancer such that one is 99.9% sure that the cancer is out, yet taking away as little of normal tissue as is safely possible. This is very important in the periocular region as one would want to make sure that there is no residual tumour left, but at the same time no unnecessary normal tissue has been excised compromising an effective and cosmetic reconstructive result.

Once the patient has had their skin cancer removed by Mohs micrographic surgery, I do the reconstruction with in 1-5 days, either under local or general anaesthesia as a day procedure, which means the patient does not require to stay overnight and would typically spend approximately 6-7 hours in the hospital.

After the operation the patient is discharged home with a full dressing over the operated eye. The dressing and sutures are removed 5-7 days post operatively in the eye clinic. Once the sutures are out, massaging the area with Vaseline, Bioil, Kelocort or E45 is essential to help with minimising the scarring.

https://www.bopss.co.uk/public-information/common-conditions/eyelid-tumours/