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An ulcer invading the lower eyelid
*Corresponding author: Gurumayum Chitralekha Devi, Department of Dermatology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India. chitralekhaguru01@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Devi GC, Sapam R. An ulcer invading the lower eyelid. CosmoDerma 2023;3:23.
A 47-year-old farmer complained of progressing ulceration invading the right lower eyelid for the past 2 years. A well-circumscribed ulcer with rolled out border, crusting, and hematoma that is continuous with congested floor containing arborizing telangiectatic vessels and total destruction of the lower eyelid was present [Figure 1]. Histopathology revealed excoriated epidermis and large telangiectatic vessels. There were islands of basaloid cells with hyperchromatic nuclei arranged in a palisading pattern with a retraction cleft. Cellular atypia with mitotic figures was also present, suggestive of basal cell carcinoma [Figure 2]. Among all basal cell carcinoma subtypes, including nodular, superficial, morphoeic, pigmented, and ulcerated basal cell carcinoma, this patient shared the feature of both ulcerated and pigmented, confirming the diagnosis clinicopathologically as a mixed pattern of ulcerative and pigmented basal cell carcinoma.
- A well-circumscribed ulcer with a rolled out variably pigmented border, crusting, and hematoma on a congested floor with arborizing telangiectatic vessels in the lower eyelid.
- Palisading islands of basaloid cells with hyperchromatic nuclei (red arrow), a retraction cleft (yellow arrow) along with large telangiectatic vessels (red star) and hemorrhagic area (yellow star) were present. Melanin incontinence was also prominently present (H&E, ×40).
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The authors certify that they have obtained all appropriate patient consent.
Conflicts of interest
There are no conflicts of interest.
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