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Arch Ophthalmol. 2000;118:422-424.

An 81-year-old man had a keratotic eyelid lesions for 20 years. He eventually sought treatment by ophthalmic plastic surgery. Clinically, the lesion resembled a keratoacanthoma. Findings from histologic examination of the excision biopsy specimen showed a squamous cell carcinoma. The lesion was completely excised. This case demonstrates the difficulty in making a correct clinical diagnosis of a keratotic eyelid lesion. Performing a histologic examination of nonregressed keratotic lesions is essential to exclude a squamous cell carcinoma.

Jane M. Olver, FRCOphth; Mohammed Muhtaseb, MBBS; Devinder Chauhan, FRCOphth; Ethna Mannion, MRCPath
From the Eye Department (Drs Olver, Muhtaseb, and Chauhan) and the Pathology Department (Dr Mannion), Charing Cross Hospital, London, England.