Basal cell carcinoma is the most common type of skin cancer. It originates from the deepest layer of the epidermis due to chronic sun exposure and UV damage to the skin cells. Basal cell carcinoma is more common in older individuals with fair skin, although it is not infrequent in people with darker skin tones. In fact, this is the most common type of eyelid carcinoma in Costa Rica. Early diagnosis of basal cell carcinoma is crucial, as the tumor may be entirely removed without permanently affecting eyelid function.
Eyelid basal cell carcinoma appears most often in the lower eyelid and inner angle of the eye (medial canthus). It begins as a reddish-pink lesion on the skin with poorly defined borders. The lesion grows slowly over months or years, and as it expands, small web-like vessels may appear in its center (telangiectasia). Later, the margins of the tumor take on a pearly white appearance with rolled-in edges. As the cancer develops, it distorts the normal anatomy of the eyelid, causing notching or ulceration. If the tumor is located on the eyelid border, lashes will start to fall out, a sign called madarosis.
The diagnosis of basal cell carcinoma may be achieved clinically when the tumor is large, or it may require an incisional biopsy. Upon diagnosis, your oculoplastic surgeon will remove the entire lesion and reconstruct the eyelid.