Commonly seen on lids near or on the margin, these can be sessile or pedunculated, and are
sometimes keratinised. These lesions are caused by the papilloma virus and are easily excised, but care must be taken if excision involves the lid margin (Figure 5.12).
This is a flat brown spot on the skin; it might have hairs, and rarely becomes malignant.
Seen as a red "strawberry mark" at or shortly after birth, this lesion can regress completely during the first few years of life. Figure 5.13 shows a gross example of the rare cavernous haemangioma, which might be disfiguring. This also can regress in a remarkable way. "Port wine stain" is the name applied to the capillary haemangioma. This is usually unilateral and when the eyelids are involved, there is a risk of association with congenital glaucoma, haeman-gioma of the choroid and haemangioma of the meninges on the ipsilateral side (Sturge-Weber syndrome). Children with port wine stains involving the eyelids need full ophthalmological and neurological examinations.
These quite common lumps are seen in or adjacent to the eyebrow. They feel cystic and are sometimes attached to bone. Typically, they present in children as a minor cosmetic problem. The cysts are lined by keratinised
epithelium and can contain dermal appendages and cholesterol. A scan might be needed before removal because some extend deeply into the skull.
These are seen as yellowish plaques in the skin; they usually begin at the medial end of the lids. They are rarely associated with diabetes, hypercholesterolemia and histiocytosis. Usually, there is no associated systemic disease.
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