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Visual Treats in Dermatology
2023
:3;
23
doi:
10.25259/CSDM_3_2023

An ulcer invading the lower eyelid

Department of Dermatology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
Corresponding author: Gurumayum Chitralekha Devi, Department of Dermatology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India. chitralekhaguru01@gmail.com
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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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.

Figure 1:: 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.
Figure 2:: 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).

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Financial support and sponsorship

Nil.


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