Diagnostic Atlas of Common Eyelid Diseases by Jonathan J. Dutton

By Jonathan J. Dutton

In contrast to the other resource at the topic, this broad-ranging consultant discusses the pathology, prognosis, and therapy of a hundred and twenty eyelid problems together with benign lesions, malignant tumors, and purchased and congenital malpositions and ailments. Written through prime researchers practiced within the research and administration of those stipulations, this resource is a must have reference for all ophthalmologists, optometrists, dermatologists, otolaryngologists, and normal plastic and reconstructive surgeons taking care of sufferers with eyelid and ocular adnexal illness.

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Solid tumors arising from the basal epithelial bulb are tichoepitheiomas. Large sebaceous glands empty into the hair follicle. Proliferations of the secretory epithelium produce solid dermal tumors called sebaceous adenomas (Fig. 4). Occasionally the excretory Figure 3 Hair follicle lesions. 32 ■ CHAPTER 4: EYELID LESIONS AND TISSUES OF ORIGIN Figure 4 The hair follicle and associated dermal lesions. Figure 5 Apocrine glands of Moll. Figure 6 The eccrine sweat gland can be the origin of several dermal lesions.

Cutler-Beard Procedure When a total or near total upper eyelid is missing the Cutler-Beard procedure is one of the major techniques available for reconstruction. A full-thickness horizontal blepharotomy is cut 4 to 5 mm below the lower lid lash line across the entire lid, and the incisions are then extended vertically to the inferior fornix to create a flap (Fig. 9). This leaves a bridge of marginal eyelid supported Figure 6 Primary layered closure is used for full-thickness marginal defects where all tissues are re-apposed in layers.

Melanin granules are dark brown and non-refractile in sections stained with hematoxylin and eosin. Melanophages are seen in the dermis in inflammatory conditions affecting the epidermis, as well as in neoplasms such as seborrheic keratosis, blue nevus, and melanomas. Necrobiosis Necrobiosis refers to death of cells or tissue due to aging or overuse. Zones of smudged or homogenized dermal collagen characterize it histologically. Necrobiosis is often seen as the center of a palisading granuloma. In granuloma annulare, the necrobiotic zone contains mucin, while in rheumatoid nodules there is usually fibrin within the necrobiotic area.

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