Ugly eyelids- tumor-like tumor on the skin of the eyelid, caused by infection with the human papilloma virus. Usually, papillomas appear only as cosmetic defects, in some areas pain, foreign bodies, and other symptoms may be present. For diagnosis, optometry, tonometry, refractometer, computed tomography, biomicroscope with slit lamp are used. Among the complementary methods, CT and biopsy were used, followed by histology of the material. Treatment of papillomas of the eyelid - removal of the tumor by means of chemical or physical destruction. Antiretroviral prescription is required.
General information
Eyelid papilloma is a tumor of the integumentary epithelium of the ocular appendage with varying degrees of dysplasia, caused by the human papilloma virus. Usually, eyelid papillomas are benign tumors, rarely malignant. These tumors account for 60–65% of all eyelid tumors. Most often (3. 5 cases per 100, 000 population) this pathology occurs in people living in equatorial countries. In Australia, the incidence is 1. 9 cases per 100, 000 population. In countries with temperate and subtropical climates, the disease is diagnosed less often. The age group of patients is over 30 years old, the average age of patients is 45-60 years old. Women are affected one and a half times more often than men.
The reasons
The leading etiological factor provoking the development of eyelid papillomas is infection with the human papillomavirus (HPV). There are more than 100 different types of papillomavirus. Human papillomavirus thrives in the epidermis of the skin, it is transmitted by direct contact with infected epithelium (usually household contact, less sexually transmitted). In addition, it can be transmitted from mother to fetus.
Factors that contribute to the development of eyelid papillomas include genetic predisposition, immune and hormonal disorders (diabetes, hyperthyroidism or hypothyroidism, menopause), pregnancy, beriberi, oftenfrequent sunbathing, cancer, smoking, drinking.
pathogenesis
It is believed that in the basal layer there are cells susceptible to the papilloma virus and enough single virus particles to stimulate the growth of eyelid papillomas. HPV is an obligate intracellular parasite usually present in an episomal form, i. e. located in the cytoplasm of cells. However, during spawning, it can move into the nucleus (integrate).
The onset of integration (the formation of papillomas of the eyelids) can occur even after 20 years from the onset of infection, the time of development of the disease is determined not only by the virus, but also by the virus itself. by the presence of the patient's genetic predisposition in combination with other factors. Even in the cytoplasm, the virus can still produce intact viral particles. At this stage, the infection is often asymptomatic, highly contagious, and easily spreads to other tissues and organs and causes eyelid papillomas.
The processes of viral replication, assembly of viral particles and their release from the cell are not fully established. In a cell, viruses can coexist in both the nucleus and the cytoplasm. When the virus enters the host body, its cytoplasmic replication begins after entering the cells of the basal layer of the skin. In the stratum corneum, there is active release of mature viral particles from cells. These areas of skin are dangerous in relation to contact infections.
eyelid papillae symptoms
The clinical picture of eyelid papillomatosis depends on the location and features of the development of the education. Size, color, shape and growth pattern can vary greatly. Usually, the papilloma is localized to the lower eyelid and does not affect vision. They are characteristic forms of yellow-gray color with growth of papillae on the surface. In the center is a ring of blood vessels.
Usually asymptomatic, patients turn to an ophthalmologist if an obvious cosmetic defect occurs due to an enlarged eyelid papilloma. When a tumor occurs at the margin of the ciliary body or at the border with the conjunctiva, the patient may complain of severe pain, foreign body sensation, blepharospasm, congestion, and decreased visual acuity. When blinking, the cornea is damaged due to the uneven papillae surface of the eyelid resulting in these symptoms.
symptoms
Complications arise when the papilloma is localized to the margin of the eyelid, to the interstitium, to the inner corner of the eye, as well as to the conjunctiva. Characterized by the development of chronic sluggish conjunctivitis, blepharitis, corneal opacities. They can disrupt eyelash growth, leading to corneal microtrauma with the development of keratitis. The formation of ectropion causes erosion and ulceration of the cornea, impaired visual function, leading to atrophy of the eyeball. In addition, eyelid papillomas always have a potential for malignancy.
diagnose
Diagnosis of eyelid papillomatosis begins with a survey and visual examination of the patient by an ophthalmologist. Then, the doctor uses standard methods of examination: optometry, tonometry, refractometry, computerized circumferential measurement, slit-lamp biomicroscopy. Among the additional methods, if necessary, optical coherence tomography or computed tomography (indicated for multiple papillomas in various locations), material is obtained for biopsy (usingimprinting, scraping or cutting), followed by histological examination. In some cases, it is necessary to consult a dermatologist.
Treatment of papillomas of the eyelids
To treat papillomas of the eyelids, chemical or physical methods of destroying the tumor are used. At the same time, antiviral drugs with immunomodulatory activity are prescribed. Methods of physical destruction include removal of eyelid papillomas by electrocautery, laser therapy, cryotherapy (destruction of the tumor with liquid nitrogen). The chemical method is based on the use of various keratolytic agents. The choice of treatment depends on the location and prevalence of the tumor, and the age of the patient. The prognosis is usually favorable.
Prevent
Precautionary measures are aimed at reducing the risk of human papillomavirus infection. Compulsory use of condoms during casual sex is recommended. If signs of HPV infection are detected, all sexual partners of the patient should be examined and adequate treatment indicated. To reduce the risk of eyelid papilloma formation, it is necessary to take measures to maintain immunity, not touch eyes with dirty hands, have a healthy lifestyle, avoid overwork and actively play sports. Refusing to go to the solarium significantly reduces the risk of eyelid papillomas.