Which eyelid cancer is most associated with sun exposure and presents with a rough, scaly surface?

• A. Basal cell carcinoma
• B. Squamous cell carcinoma
• C. Adenocarcinoma
• D. Melanoma

Answer: (B)

Squamous cell carcinoma of the eyelid is strongly linked to sun exposure and usually shows up as a rough, scaly, crusted surface, and it may ulcerate. This keratotic, crusty appearance comes from the malignant squamous cells forming keratin on the surface. Basal cell carcinoma, while also sun-related, more often looks like a pearly, translucent nodule with telangiectasias and a rolled border rather than a rough, scaly surface. Sebaceous or adenocarcinoma of the eyelid tends to present with eyelid thickening, madarosis (loss of eyelashes), or a masquerade as a chalazion, not a gritty, scaly lesion. Melanoma can be pigmented or amelanotic and irregularly bordered, but the classic rough, scaly texture aligns best with squamous cell carcinoma. Early recognition and complete surgical excision with clear margins are important due to a higher risk of invasion and potential metastasis with this type.