A 65-year-old man was concerned about a skin-colored papillary lesion on the right lateral lower eyelid along the eyelash line. It had been present for 1 week and was asymptomatic.
The lesion was excised, and its base was lightly electrodesiccated. Topical antibiotic ointment was applied for several days. The site healed without complication.
The histopathological diagnosis was inverted follicular keratosis. This benign, solitary, nodular tumor arises from the follicular infundibulum. It may grow up to 1 cm in diameter in 1 of 4 patterns: a papillomatous wart-like variant, a keratoacanthoma-like pattern, a solid nodular form, or an uncommon cystic type.1 The lesion occurs most often on the head, neck, cheek, and upper lip; it is more common in males and older persons.
1. Weedon D. Skin Pathology. 2nd ed. London: Churchill Livingstone; 2002:867.