What could be responsible for this man's periorbital lesion?
A 62-year-old man presented for evaluation of a crusted lesion on the lateral lower right eyelid. It was asymptomatic and had been present for a few months. He was otherwise healthy.
What could be responsible for this man's periorbital lesion?
- Actinic keratosis
- Basal cell carcinoma
- Squamous cell carcinoma
- Seborrheic dermatitis
- Rosacea blepharitis
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Answer: Actinic keratosis
This lesion was an actinic keratosis. There was no underlying induration, which would have suggested the possibility of a basal cell carcinoma or squamous cell carcinoma. This lesion can be treated with cryosurgery (usually applied with a cotton-tipped swab when this close to the eyeball) or a topical modality such as fluorouracil, imiquimod, or diclofenac. Seborrheic dermatitis usually is scaly rather than crusted. Rosacea blepharitis affects the eyelid margin, unlike what is seen here.