Skin Cancer of the eyelids poses several diagnostic and management challenge. As a referral specialist, I see these patients well after a significant progression has occurred and the diagnosis is fairly obvious. The excision and reconstruction if these tumors requires a great degree of creativity and flexibility to achieve the optimal result.
The ultraviolet radiation that is primarily responsible for malignant transformation of skin cancer are 290 to 320 nm(UV-B). The most common malignancies affecting the periocular region are basal cell carcinoma, squamous cell carcinoma, sebaceous cell carcinoma, and malignant melanoma. Basal cell carcinoma accounts for 90% of all eyelid malignancies. The tumor primarily involves the lower eyelid (50% to 66%) and the medial canthus (25% to 30%). The upper eyelid is affected in 15% of cases and the lateral canthus in 5%. Although these statistics are helpful, many skin cancers involve adjacent anatomic areas such as the forehead and cheek, and pose even greater challenges in reconstruction.
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