Intraepithelial sebaceous carcinoma of the conjunctiva and skin of the eyelid.

The authors report a 65-year-old woman with a 10-year history of conjunctivitis and progressive loss of lashes due to widespread intraepithelial sebaceous carcinoma of the conjunctiva and skin of the eyelid. After surgery, serial sections of the entire conjunctiva and eyelids showed a single focus of invasive carcinoma in the bulbar conjunctiva, which probably arose from the epithelium. The absence of cilia on the affected lower lid was associated with neoplastic obliteration of the cilial orifices and low-grade, smoldering lipogranulomatous inflammation. This type of tumor-related alopecia is likely to masquerade as blepharitis because there is no identifiable tumefaction or clinical evidence of recurrent chalazia to suggest an underlying sebaceous carcinoma. The 10-year history of "conjunctivitis" before diagnosis indicates that intraepithelial sebaceous carcinoma may have a prolonged clinical course.