Pilomatrixoma of eyelid in a middle aged.

BACKGROUND Pilomatrixoma , also known as Malherbes's calcifying epithelioma, known to occur in children, is not common especially in middle aged and those below 10 years of age . Pilomatrixoma presents as a firm skin nodule on eye lid or eye brow, so should be considered in the differential diagnosis of such lesions involving eyelids. CASE A 45-year-old male presented with a swelling in the left upper lid for the last 4 months. There was firm to hard non tender nodule measuring 1.5 cm. x 1.5cm in size on the lateral aspect of the left upper eye lid , involving the lid margin with variegated appearance of overlying skin with a few ulcerated areas on the surface. A presumptive diagnosis of meibomian gland carcinoma was made and an excision biopsy with primary lid repair was carried out. Histopathological examination confirmed the diagnosis of pilomatrixoma. CONCLUSION The present case is reported to sensitize the ophthalmologists to think beyond chalazion and meibomian gland carcinoma for a firm, nodular, non ulcerated, painless lid swelling.