Scott K R, Jakobiec F A, Font R L
Department of Ophthalmology, Manhattan Eye, Ear & Throat Hospital, New York.
Ophthalmology. 1989 Jul;96(7):994-8.
A peripunctal nevus is a rare lesion of the eyelid margin, six examples of which are included in this report. The lesions all involved the lower punctum and had been present for many years without producing epiphora. In addition to their variable clinical pigmentation and translucent appearance on biomicroscopy, all shared several other diagnostically useful clinical features: an overall dome-shape with a fine micronodularity; a prominent ramifying vascularity; and, most importantly, circumferentially swollen punctal lips that created a slit-like punctal orifice. Histopathologically, the lesions were predominantly or exclusively subepithelial melanocytic nevi and were demonstrated not to compress the punctum or canaliculus. Infiltration of the nevus cells within the orbicularis striated muscle fibers was a common finding owing to the latter's superficial location in the eyelids. If patients request excision for cosmetic reasons, these lesions are best managed by a horizontal circular shave excision with the temporary placement of a silicon punctual plug. The differential diagnosis includes cyst, papilloma, melanoma, and basal cell carcinoma.
睑缘周痣是一种罕见的睑缘病变，本报告纳入了6例。所有病变均累及下泪点，且已存在多年未导致溢泪。除了其临床色素沉着各异以及在生物显微镜下呈半透明外观外，所有病变还具有其他几个有助于诊断的临床特征：整体呈圆顶状，有细微的小结节；血管分支明显；最重要的是，泪点唇周缘肿胀，形成裂隙样泪点开口。组织病理学上，病变主要或完全为上皮下黑素细胞痣，且未压迫泪点或泪小管。由于睑轮匝肌纤维位置表浅，痣细胞浸润其中是常见表现。如果患者出于美容原因要求切除，这些病变最好采用水平环形削切术，并临时放置硅胶泪点塞进行处理。鉴别诊断包括囊肿、乳头状瘤、黑色素瘤和基底细胞癌。
