What is Eyelid Papilloma?
The eyelid, despite being small, is vital in protecting our eyes. The skin on the eyelid is the thinnest in our body and lacks fat under it. Because of their features and location, the eyelids are more likely to be affected by irritants and damage from ultraviolet rays. As a result, they are more prone to developing harmless and dangerous eyelid tumors. According to research, 5 to 10 percent of all skin cancers develop on the eyelids.
A kind of eyelid growth, called a papilloma, refers to a harmless excessive growth of skin cells that can affect the eyelid skin. These growths aren’t necessarily linked to the papillomavirus, which causes warts. Although these growths are not dangerous, they might cause minor irritation or be a cosmetic concern for the patient. However, it’s important to know the difference between a harmless growth like a papilloma and a potentially harmful growth on the eyelid. There are many types of growths that can appear on the eyelids, including seborrheic keratosis, pseudoepitheliomatous hyperplasia, inverted follicular keratosis, verruca vulgaris, squamous papilloma (also known as skin tag), basosquamous acanthoma, and squamous acanthoma, among others. Some of these are explained below:
Squamous papilloma, also known as a skin tag, is a soft, flesh-colored growth that is smooth, round, and/or hanging off the skin.
Seborrheic keratosis is a harmless growth of cells that often looks like it’s stuck on the skin and can be various shades, ranging from pink or flesh color to dark brown. While these growths are usually harmless, if many of them suddenly appear in one area of the body, it could indicate another disease process. These growths usually have a reddened base, known as Leser-Trelat sign.
Pseudoepitheliomatous hyperplasia refers to growths often formed in response to injury, burns, drugs, and so forth. They can look similar to basal cell or squamous cell carcinoma, which are types of skin cancer. These growths are usually raised on the skin with an uneven surface and occasional crusting or sores.
Inverted Follicular Keratosis is usually a single growth affecting the eyelid edge. It can be pigmented or not and is usually lump-like or papilla-like in appearance.
Verruca vulgaris is a flesh-colored skin growth caused by the human papillomavirus and is rare on the eyelid.
What Causes Eyelid Papilloma?
Papillomas, which involve the growth of skin cells, are caused by different things depending on the type. Certain types, like squamous papillomas and seborrheic keratosis, are considered benign, meaning they are not cancerous. We don’t fully understand what causes these, so they are said to be ‘idiopathic’.
On the other hand, there are some skin growths that can look like papillomas but are actually cancerous. These are often linked to long-term exposure to the sun’s ultraviolet (UV) rays and skin that has been damaged by the sun.
Verruca vulgaris, a common type of wart, is caused by certain types of human papillomavirus (HPV), specifically type 6 or 11.
Risk Factors and Frequency for Eyelid Papilloma
Research indicates that the majority of eyelid tumors are of epidermal origin. One study identified a common skin condition, seborrheic keratosis, as the most frequently seen lesion, with squamous cell papilloma coming next. However, another study reported squamous papillomas as the most prevalent benign epithelial tumor on the eyelid. People usually encounter seborhheic keratosis in middle age or later. The occurrence of squamous papillomas doesn’t favor a certain race or sex. Although their incidence generally increases with age, they can occur at any point in a person’s life.
- Epidermal tumors make up most of the eyelid tumors.
- Seborrheic keratosis is often the most common lesion, followed by squamous cell papilloma, according to a study.
- Another study reportedly found squamous papillomas to be the most common benign epithelial eyelid tumor.
- Seborrheic keratosis usually occurs in middle-aged or older patients.
- Squamous papillomas can happen to individuals of any race or sex and at any age, though is more common with increasing age.
Signs and Symptoms of Eyelid Papilloma
When you see a doctor about a skin mark on your eyelid, they’re going to ask you some critical questions. This includes how long it’s been there and whether it’s changed in color, size, or shape. They’ll also ask if it hurts, if it’s leaked any fluid, and if you’ve had similar marks before. If you’ve ever had skin cancer, they’ll be especially diligent in their examination.
People who have eyelid papillomas, a type of skin growth, usually report that they’ve had them for quite a while without any significant changes. These growths don’t usually cause symptoms, but occasionally they might feel heavy or slightly inflamed. They don’t generally bleed or leak unless they’ve been irritated and become infected. A history of skin cancer could make a doctor pay closer attention to the growth.
The doctor will then perform a physical exam. During this exam, they will:
- Check the surrounding skin for any other growths
- Feel along your face and neck for any swollen lymph nodes
- Use a special tool, called a slit lamp, to look closely at the growth and evaluate if there’s any damage to nearby tissues
What they see during this exam can differ depending on the type of growth. For instance, a squamous papilloma is typically a soft, flesh-colored round growth. A seborrheic keratosis has a “stuck on” appearance and can range in color from pink to dark brown. Pseudoepitheliomatous hyperplasia usually occurs in response to an injury and can look similar to certain types of skin cancer. Inverted follicular keratosis is usually a single growth along the eyelid and it might have a bumpy or ridged appearance. Finally, a verruca vulgaris is a flesh-colored growth that might have tiny, fingerlike projections at its top.
Testing for Eyelid Papilloma
If there is a wound or abnormal spot on your skin, it might be helpful for your doctor to take a photo or make a sketch to track any changes over time.
If this skin issue has any signs that might suggest it could be cancerous, your doctor might decide to do a biopsy. A biopsy is a procedure where a small sample of tissue is removed from the body to look for disease. In this case, they might do what’s called an “incisional biopsy”, where a piece of the tissue is cut out and examined.
Treatment Options for Eyelid Papilloma
Eyelid papillomas, also known as small, harmless growths on the eyelid, can be left alone and observed. But if they’re causing discomfort or you don’t like their appearance, they can be removed. A lot of these papillomas can be taken off with a straightforward procedure at the doctor’s clinic. Alternatively, if a papilloma is similar to a common wart (verruca vulgaris), it might respond better to a treatment known as cryotherapy, which uses freezing temperatures to remove the abnormal tissue.
Medical research has shown other effective methods for treating larger eyelid papillomas. One of these includes injecting a substance called interferon directly into the growth. Another is using a device that employs radiofrequency – a type of energy waves – to remove the eyelid growth. In a study involving 64 patients with similar growths on their eyelids, this method was found safe and effective for up to 72% of the lesions treated, most of which were squamous papillomas – a type of skin growth that is usually not dangerous.
The process of removing an eyelid papilloma usually involves using a local anesthetic to numb the area and a set of delicate instruments like forceps and a small blade or scissors to remove the growth. Typically, the cut left behind is small and doesn’t require stitches. After the procedure, you might be prescribed an antibiotic ointment.
Your doctor might also send the removed tissue for further testing in a laboratory, especially if there’s anything unusual about it. This is done to make sure that the growth isn’t harmful. Overall, the removal of eyelid papillomas is typically a safe and simple procedure that can provide relief from irritation and improve your appearance.
What else can Eyelid Papilloma be?
When diagnosing a certain condition, a doctor might need to consider other diseases or conditions that have similar symptoms. These are known as differential diagnoses. For some eye and skin problems, the differential diagnoses can include:
- Chalazion or Hordeolum (common types of eyelid bumps)
- Epidermal inclusion cyst (a type of skin cyst)
- Molluscum contagiosum (a skin infection caused by a virus)
- Xanthelasma (yellowish patches on the skin, usually around the eyes)
- Squamous cell carcinoma (a type of skin cancer)
- Nevus (a mole or birthmark)
- Actinic keratosis (scaly spots caused by sun damage)
- Basal cell carcinoma (a common type of skin cancer)
- Sebaceous gland carcinoma (a rare type of skin cancer that starts in the oil glands)
