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. 2023 Aug 22:103:adv4500.
doi: 10.2340/actadv.v103.4500.

Unusually Aggressive Actinic Keratosis of the Eyelid and Conjunctiva

Jana Al-Hage  1 , Julien Masliah-Planchon  2 , Pierre Sohier  3 , Livia Lumbroso-Rouic  4 , Ivan Bieche  5 , Selim Aractingi  6
Affiliations

Unusually Aggressive Actinic Keratosis of the Eyelid and Conjunctiva

Jana Al-Hage et al. Acta Derm Venereol. .
No abstract available

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
(a, b) Initial clinical presentation in 2010, with a scaly erythematous plaque, affecting the free border of the left eyelid and extending upward to the eyebrow, initially without conjunctival involvement. (c–d) Relapse in 2015, with conjunctival involvement: papillomatous hyperaemic plaques of the temporal bulbar conjunctiva, extending from the limbus to the lateral canthus and to the superior palpebral conjunctiva. (e, f) Histological analysis showed evidence of actinic keratosis without evidence of invasion (e: haematoxylin and eosin (H&E) ×4; f: H&E ×10, inset ×40).
Fig. 2
Fig. 2
(a) Progressive disease despite topical treatment leading to a non-functional eye with excruciating pain. (d, e) Evisceration with reconstructive surgeries (using Cutler Beard flap) were performed in 2016, and histopathological analysis showed conjunctival leukokeratosis with few focal lesions of low-grade intra-epithelial neoplasia but without any evidence of invasion. (b, c) However, new actinic keratoses (AK) continued to appear over the remnant of the eyelid despite many topical treatments over 4 years. (f) Orbital exenteration and grafting were then done, but the patient was still developing cutaneous AK lesions in proximity to the skin graft even 6 months later. (d: H&E, ×4; e: H&E, ×10).
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