The skin of the eyelids is a common site for benign and malignant growths.
Xanthelasma is a common, benign deposit of yellow-white flat plaques of lipid material that occur subcutaneously on the upper and lower eyelids. Although some people with xanthelasmas have dyslipidemias, most do not. Diagnosis is by appearance. No treatment is necessary, although xanthelasmas can be removed for cosmetic reasons, and underlying dyslipidemias should be treated.
Basal cell carcinoma frequently occurs at the eyelid margins and classically is associated with loss of eyelashes as shown, at the inner canthus, and on the upper cheek. Metastasis is rare. Biopsy establishes the diagnosis. Treatment is surgical excision using conventional techniques or by Mohs surgery.
Other types of malignant growths are less common; they include squamous cell carcinoma, sebaceous gland carcinoma, and melanomas. Eyelid growths may simulate chronic blepharitis or chronic chalazion. Therefore, chronic blepharitis, chronic chalazion, or similar lesions should be biopsied if unresponsive to initial treatment.