The Dumbbell on the Eyelid

Epidermal Inclusion Cyst (also known as Epidermoid cyst or Sebaceous cyst) is a benign encapsulated, sub-epidermal nodule filled with keratin material. This is one of the commonest masses seen in the eyelid. Though it is commonly seen in the face and neck, it can occur anywhere in the body. These masses can become unsightly and large enough to cause problems in field of vision like in this case. These can be easily removed with scars that can be hidden among the natural lines of the face like in this case.

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The Dumbbell on the Eyelid As promised, revealing the histopathological diagnosis of the Dumbbell shaped mass shown in the previous post. Epidermal Inclusion Cyst (also known as Epidermoid cyst or Sebaceous cyst) is is a benign encapsulated, sub-epidermal nodule filled with keratin material. This is one of the commonest masses seen in the eyelid. Though it is commonly seen in the face and neck, it can occur anywhere in the body. These masses can become unsightly and large enough to cause problems in field of vision like in this case. These can be easily removed with scars that can be hidden among the natural lines of the face like in this case. Eyelid Lumps & Bumps Surgery ⏲Surgery time: 10-20 mins depending on the size of the eyelid mass. 💉Anaesthesia: Done under Local 🗓️Downtime: 1 week 📈Duration of effect: Permanent, though similar lesions can occur in other areas of the face and body. 📠 Phone: +91 80 2502 3257 📩 E-mail:dr.raghuraj.hegde@gmail.com 🖥️ Website: www.drraghurajhegde.com Pic 1: Right upper eyelid mass and Left Lower lid mass. Pic 2: Swipe ➡️ to see masses excised using the right upper eyelid crease and left sub-ciliary incision so that incisions heals without any visible scars. Intact keratin filled cysts excised with clean dissection planes and minimal leakage. Pic 3: Histopathology of the lesion showing the cyst wall with keratin material within the cyst. ©All patient photos are being used with the express consent of the patient. These cannot be shared or reproduced elsewhere.

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Eyelid Lumps & Bumps Surgery

⏲Surgery time: 10-20 mins depending on the size of the eyelid mass.
💉Anaesthesia: Done under Local
🗓️Downtime: 1 week
📈Duration of effect: Permanent though similar lesions can occur in other areas of the face and body.
📠 Phone: +91 80 2502 3257
📩 E-mail:dr.raghuraj.hegde@gmail.com
🖥️ Website: www.drraghurajhegde.com

Pic 1: Right upper eyelid mass and Left Lower lid mass.
Pic 2: Swipe to see masses excised using the right upper eyelid crease and left sub-ciliary incision so that incisions heals without any visible scars. Intact keratin filled cysts excised with clean dissection planes and minimal leakage.
Pic 3: Histopathology of the lesion showing the cyst wall with keratin material within the cyst.

©All patient photos are being used with the express consent of the patient. These cannot be shared or reproduced elsewhere.

Pathophysiology of Epidermoid Cyst

It is caused by the implantation of the epidermal cells into the dermis causing a cyst filled with keratin material. Usually there is communication of the cyst with the skin through a keratin filled pore called punctum. In this particular case, interestingly there was no characteristic pore which made the clinical diagnosis a little tricky.

The differential diagnoses include Lipoma, Schwannoma, Dermoid Cyst, Steatocytoma, Furuncle, Milia, Chondroid Syringoma.

The sizes of epidermoid cysts can vary from very small lesions (milia) in children to very large to very numerous in adults. Most cases are sporadic and have no genetic basis but epidermoid cysts can be seen certain genetic syndromes like Gardner’s and Gorlin’s too. Imiquimod and Cyclosporine have been known to cause epidermoid cysts.  Recently, UltraViolet (UV) light and Human Papilloma Virus (HPV) has been implicated in the causation of epidermoid cysts. Less than 1% of these masses turn malignant to become Squamous Cell Carcinoma (SCC).

If you have lumps and bumps on the eyelids, have it easily removed. Do not wait it it becomes large and unsightly.

Published by Dr. Raghuraj Hegde

Free thinker| Poet| Writer| Traveller| Doctor| Ophthalmic Plastic Surgeon

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