Lesions of the eyelids are very common and can be benign or malignant. A biopsy is required for the definitive diagnosis. The eyelids are one of the common sites in the body for cancers.
Why does my lesion need to be excised?
Although some lesions do not cause problems, you may want to have them removed for functional reasons, for diagnostic purposes and some may appear unsightly. Surgery is recommended to remove skin lesions that show any signs of turning cancerous.
What type of biopsy of the eyelid lesion can be done?
A punch biopsy is often done with a circular blade. This blade is attached to a pencil-like handle and is rotated down removing a cylindrical core of tissue.
An incisional biopsy removes part of the lesion rather than the whole thing (mostly for diagnostic purposes before planning the definitive procedure). A punch biopsy is also an incisional biopsy. These deliberately leave a portion of the lesion behind and a marker for when the excisional biopsy is undertaken.
An excisional biopsy involves the removal of the whole lesion, sometimes including not only the affected area but part of the surrounding normal skin. This is to show the interface between normal and abnormal skin for histology and to ensure adequate clearance margins.
Mohs surgery is a type of biopsy undertaken in a separate center by a Mohs surgeon (in a specialist unit in Central London). It is microscopically controlled with the aim being to excise as much abnormal tissue as possible and also to spare as much healthy skin as possible. The excision may be overtaken over the course of one day or sometimes on two different days. The specimen is usually histologically examined by the dermatologist who undertook the excision. Reconstruction with be undertaken by Mr Saleh.