Conjunctival Sebaceous Carcinoma Masquerading As Chronic Blepharoconjunctivitis

The masquerade syndrome was first described by Theodore (1), and Irvine (2) independently in 1967, as chronic blepharoconjunctivitis due to an underlying conjunctival carcinoma. Conjunctival intraepithelial neoplasia and sebaceous cell carcinoma have been reported to show intraepithelial (pagetoid) spread to the conjunctiva mimicking chronic blepharoconjunctivitis, or cicatrizing conjunctivitis (3,4). These lesions have no distinct borders and therefore, may be clinically indistinguishable from the uninvolved tissue. Patients with this form of the disease are more prone to having multiple tumor recurrences and requiring multiple surgeries with poorer outcomes, largely because of the difficulty and delay in diagnosis and treatment.