PRE-SEPTAL Cellulitis PDF

PRE-SEPTAL CELLULITIS: common infection of eyelid + periorbital soft tissues - Acute eyelid erythema - Eyelid oedema - Mainly affecting children: 80% medial > superior > temporal - Stem from the basal layer – deepest layer of the skin - Most common among light skinned individuals...

PRE-SEPTAL CELLULITIS: common infection of eyelid + periorbital soft tissues - Acute eyelid erythema - Eyelid oedema - Mainly affecting children: 80% medial > superior > temporal - Stem from the basal layer – deepest layer of the skin - Most common among light skinned individuals with high uv exposure - Incidence of BCC increase with age – peaking in the seventh decade of life - M>F: 3:2 - More in immunocompromised who have been on immunosuppresants for many years THREE MAIN BCC TYPES: a) NODULAR – small, translucent, poorly defined borders, firm to touch b) ULCERATIVE – classic ulcerative presentation is a nodular lesion, reddish hue due to permanent blood vessels along the surface, pearly appearance, excavated centre c) MORPHEIC: firm, pale, waxy yellow plaque with indistinct borders which may spread underneath skin surface SIGNS: - May present as a change in lid contour/direction - Redirection/loss of eyelashes - Texture of surrounding skin may be lost - Secondary infection/inflammation may be evident - Referral necessary - If left untreated: can metastasise and can threaten sight MANAGEMENT: - Surgical removal - Skin grafting may be required if large - Cryotherapy - Radiation therapy - Early detection: good prognosis SQUAMOUS CELL CARCINOMA: - Rare - More aggressive malignancy than BCC - 2nd most common eyelid malignancy: 5% of all eyelid lesions - Mostly in the elderly - Fair skinned individuals - History of chronic sun exposure - Associaton with other pre-cancerous lesions: actinic keratosis, bowen dermatosis - Immunocompromised pxs - Px exposed to oil/tar - Xeroderma pigmentosa association BENIGN EYELID LESIONS: - Cysts from any of the glands around the eyelid margin - CYSTS OF MOLL: benign clear fluid-filled cysts occurring upper/lower lid margins - CYSTS OF ZEISS: small sebaceous glands assoc with lash follicles, blockage of lash follicles leads to accumulation of yellow/white sebaceous material - Removal of these two will only be for cosmetic purposes - MOLLUSCUM CONTAGIOSUM: benign skin lesion Contagious Spreads through direct contact Lesion can be single/multiple Dome shaped waxy nodule 2-3mm in diameter Release toxic viral products can lead to follicular conjunctivitis THYROID EYE DISEASES: - Most common present in women in their 4th to 6th decade - Graves Disease (autoimmune thyrotoxicosis) - SYSTEMIC SYMPTOMS: tremor, mood change/irritability, weight loss, tachycardia) - OCULAR SYMPTOMS: proptosis, lid retraction, lid lag, irritation due to corneal dryness, lid oedema, conjunctival chemosis, serious complication of optic nerve compression (