eyelid papilloma- Tumor-like tumors on the skin of the eyelids, caused by human papillomavirus infection. Usually, papillomas present as cosmetic defects only; in some locations, pain, foreign body sensation, and other symptoms may be present. For diagnosis, acumetry, tonometry, refractometry, computerized perimetry, biomicroscope with slit lamp are used. In other methods, CT and biopsy followed by histology of the material are used. Treatment of eyelid papillomas - removal of tumors using chemical or physical destruction methods. Prescription of antiviral drugs is mandatory.
General information
Eyelid papillomas are neoplasms of the epithelial epithelium of the ocular adnexa with varying degrees of dysplasia caused by human papillomavirus. In most cases, eyelid papillomas are benign tumors, and malignant tumors are rare. These tumors account for 60-65% of all eyelid tumors. Most often (3. 5 cases per 100, 000 people), this pathology occurs in people living in equatorial countries. In Australia, the prevalence rate is 1. 9 cases per 100, 000 people. The disease is diagnosed less frequently in countries with temperate and subarctic climates. The age group of patients is over 30 years old, and the average age of patients is 45-60 years old. Women are one and a half times more likely to get sick than men.
reason
The main cause of the development of eyelid papillomas is infection with the human papillomavirus (HPV). There are more than 100 different types of papillomaviruses. Human papillomavirus is tropical to the epidermis and is transmitted by direct contact with infected epithelial cells (most often by household contact, less often sexually). 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, frequent visits to the solarium, cancer, smoking, alcohol consumption.
onset
It is believed that the presence of papillomavirus-sensitive cells in the basal layer and individual virus particles sufficient to stimulate the development of eyelid papillomas. HPV is an obligate intracellular parasite that usually exists episomally, that is, in the cytoplasm of cells. However, during reproduction it can migrate into the nucleus (integrate).
Integration (formation of eyelid papillomas) can occur even 20 years after the onset of infection, and the timing of disease development depends not only on the virus but also on the patient's genetic predisposition in combination with other factors. Even in the cytoplasm, viruses are capable of producing intact virus particles. Infection at this stage is often asymptomatic and highly contagious. It can easily spread to other tissues and organs and cause eyelid papilloma.
The processes of viral replication, assembly of virions and their release from cells are not fully defined. In a cell, viruses can exist in both the nucleus and the cytoplasm. When a virus enters a host organism, its cytoplasmic replication begins after penetrating cells in the basal layer of the skin. In the stratum corneum, cells actively release mature virus particles. These areas of skin are dangerous in terms of exposure to infection.
eyelid papilloma symptoms
The clinical presentation of eyelid papilloma depends on the location and characteristics of growth education. Size, color, shape and growth patterns can vary widely. In most cases, papillomas are located on the lower eyelid and do not affect vision. They are characteristic exophytic structures of grayish yellow with papillary growths on the surface. In the middle is the vascular ring.
Usually they are asymptomatic, and patients refer to an ophthalmologist if there are significant cosmetic defects due to the increase of eyelid papillomas. When tumors arise at the ciliary border or at the junction with the conjunctiva, patients may complain of severe pain, foreign body sensation, blepharospasm, hyperemia, and decreased vision. When you blink, the uneven surface of eyelid papillomas can damage the cornea, causing these symptoms.
complication
Complications arise when papillomas are located in the ciliary margin of the eyelid, in the marginal space, in the inner corner of the eye area, and when the tumor spreads to the conjunctiva. Characterized by the development of chronic chronic conjunctivitis, blepharitis, corneal opacity. They cause failure of eyelash growth, which leads to corneal microtrauma and development of keratitis. The formation of eversion leads to corneal erosion and ulceration, impaired visual function, and even atrophy of the eyeball. In addition, there is always a risk of malignant transformation of eyelid papillomas.
diagnosis
The diagnosis of eyelid papilloma begins with an ophthalmologist's examination and visual inspection of the patient. Doctors then use standard examination methods: acumetry, tonometry, refractometry, computerized perimetry, biomicroscopy with a slit lamp. In other methods, if necessary, using optical coherence tomography or computed tomography (specified for multiple papillomas at different locations), material is biopsied (using stamping, scraping, or cutting) and then histologicallyacademic inspection. In some cases, a consultation with a dermatologist is required.
Treatment of eyelid papilloma
To treat eyelid papillomas, chemical or physical methods that destroy the tumor are used. At the same time, antiviral drugs with immunomodulatory activity are prescribed. Physically destructive methods include removal of eyelid papillomas using electrocoagulation, laser therapy, cryotherapy (tumor destruction with liquid nitrogen). Chemical methods are based on the use of various keratolytics. The choice of treatment regimen depends on the location and prevalence of the tumor, and the age of the patient. Prognosis is usually favorable.
prevention
Preventive measures aim to reduce the risk of contracting HPV. Mandatory condom use is recommended during casual sex. If signs of HPV infection are detected, all sexual partners of the patient will need to be tested and booked for appropriate treatment. To reduce the risk of eyelid papilloma formation, it is necessary to take measures to maintain immunity, not to touch eyes with dirty hands, lead a healthy lifestyle, avoid overexertion and be active in sports. Refusing to go to the solarium can significantly reduce the risk of eyelid papillomatosis.