eyelid papillomas- tumor-like neoplasm on the skin of the eyelid as a result of infection with the human papillomavirus. Usually, papillomas appear only as a cosmetic defect, in some localizations, pain, sensation of a foreign body and other symptoms are possible. For diagnostics, visiometry, tonometry, refractometry, computerized perimetry, biomicroscopy with a slit lamp are used. Of the additional methods, CT and biopsy are used, followed by histology of the material. Treatment of papillomas of the eyelids -Removal of the tumor using chemical or physical methods of destruction. Prescription of antiviral drugs is mandatory.
General Information
Eyelid papillomas are tumors of the integumentary epithelium of the adnexal apparatus of the eye with varying degrees of dysplasia caused by human papillomavirus. Most often, papillomas of the eyelids are benign tumors, malignancy is rare. These neoplasms are the most common of all eyelid neoplasms. accounts for 60-65%. Most often (3. 5 cases per 100, 000 population) this pathology occurs in people living in equatorial countries. In Australia, the prevalence is 1. 9 cases per 100, 000 population. TemperateAnd in countries with a subarctic climate, the disease is diagnosed less frequently. The age group of patients is more than 30 years old, the average age of patients is 45-60 years. Women get sick one and a half times more often than men.
cause
The major etiological factor provoking the development of eyelid papilloma is infection with human papillomavirus (HPV). There are more than 100 different types of papillomavirus. Human papillomavirus is tropical for the epidermis of the skin, it is transmitted by direct contact with infected epithelium (oftenContact-occurs household, less often sexual transmission). In addition, it can be transmitted from mother to fetus.
Factors contributing to the development of eyelid papillomas include genetic predisposition, immunological and hormonal disorders (diabetes mellitus, hyper- or hypothyroidism, menopause), pregnancy, beriberi, frequent visits to the solarium, cancer, smoking, alcohol consumption.
pathogenesis
It is believed that the basal layer contains cells sensitive to papillomavirus and that single particles of virus are sufficient to stimulate the growth of an eyelid papilloma. HPV is an obligate intracellular parasite that normally resides in the cytoplasm of the cell as an episomal molecule. However, during reproduction, it can migrate to the nucleus (integration).
The onset of consolidation (formation of papillomas of the eyelids) is possible even after 20 years from the onset of infection, the timing of the development of the disease is determined not only by the virus itself, but also by the presence of a hereditary predisposition of the patient in combination with other factors. In. Even while in the cytoplasm, the virus is able to produce intact viral particles. At this stage, the infection is often asymptomatic, highly contagious, and can easily spread to other tissues and organs and cause eyelid papillomas. Could
The process of virus replication, assembly of viral particles and their release from the cell has not been fully established. In a cell, the virus can exist simultaneously in both the nucleus and the cytoplasm. When the virus enters the host organism, itsCytoplasmic replication begins after penetration into the cells of the basal layer of the skin. In the stratum corneum, there is an active release of mature viral particles from the cells. These areas of the skin are dangerous with respect to contact infection.
Symptoms of eyelid papilloma
The clinical picture of eyelid papilloma depends on the location and characteristics of the growth of education. Size, color, shape and growth pattern can be very different. Most often, papillomas are localized on the lower eyelid and do not affect visual acuity. TheyOn the surface there are characteristic exophytic formations of a brownish-yellow color with papillary growths. In the center there is a vascular loop.
Usually they are asymptomatic, if there is an obvious cosmetic defect caused by an increase in eyelid papilloma, the patient turns to an ophthalmologist. When a neoplasm appears on the ciliary edge or on the border with the conjunctiva, the patient isThere may be complaints of severe pain, foreign body sensation, blepharospasm, hyperemia and reduced vision. During blinking, the cornea is damaged by the uneven surface of the papilloma of the eyelid, leading to the onset of these symptoms.
complications
Complications arise when the papilloma is localized in the region of the inner corner of the eye, in the intermarginal space, on the ciliary edge of the eyelids, and when the neoplasm spreads to the conjunctiva. Chronic sluggish conjunctivitis, blepharitis, is characterized by the development of corneal opacity. They can cause eyelash growth disorders, which leads to microtrauma of the cornea with the development of keratitis. Corneal erosion and ulceration, impaired visual function, from the formation of ectropion to atrophy of the eyeball. In addition, always eyelid papillomaThere is a risk of being fatal.
diagnosis
Diagnosis of eyelid papilloma begins with a survey and visual examination of the patient by an ophthalmologist. Then the doctor uses standard examination methods: visiometry, tonometry, refractometry, computerized perimetry, biomicroscopy with a slit lamp. Among additional methods, if necessary, optical coherence tomography or computed tomography is used (appointed for multiple papillomas of different localization), material is taken for biopsy (using an impression, scraping or cut) followed by a histological examinationIn some cases, consultation with a dermatologist is necessary.
Treatment of papillomas of the eyelids
For the treatment of papillomas of the eyelids, chemical or physical methods of destruction of the neoplasm are used. At the same time, antiviral drugs with immunomodulatory activity are prescribed. Physical destructive methods include electrocoagulation, laser therapy, cryotherapy (with liquid nitrogenwith destruction of the neoplasm) involves the removal of the eyelid papilloma using. The chemical method is based on the use of various keratolytic agents. The choice of treatment option depends on the location and prevalence of the neoplasm, the age of the patient. The prognosis is often favorable.
Redressal
Preventive measures are aimed at reducing the risk of infection with human papillomavirus. The mandatory use of condoms during casual sex is recommended. If symptoms of HPV infection are found, all sexual partners of the patient should be examined and treated adequately. appointment is required. To reduce the risk of formation of eyelid papillomas, it is necessary to take measures to maintain immunity, do not touch the eyes with dirty hands, lead a healthy lifestyle, avoid overwork andActively play sports. The risk of papillomas of the eyelids is significantly reduced by the refusal to visit the solarium.