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Yellow eyelids are an uncommon finding but can be cosmetically disfiguring to a patient. There are a variety of causes of yellow eyelids. A case study as well as the differential diagnosis of yellow eyelids are presented.
Yellow eyelids are an uncommon finding. It is important for dermatology health care providers to understand the causes and diagnose the characteristics of yellow eyelids.
Case Study
A 69-year-old white woman presented with a 1-year history of upper eyelid nodules and a 2-month history of yellow eyelid discoloration. She was disturbed by the cosmetic disfigurement of the discoloration. Her primary care physician as well as her ophthalmologist saw her and she was referred to dermatology. Her past medical history was significant for aortic valve replacement in 1992 and 1980, lower gastrointestinal hemorrhage in 1990, appendectomy in 1960, rheumatic heart disease, and hypertension.
Physical Examination
Physical examination revealed bilateral upper eyelid nodules measuring 2 centimeters by 1.5 centimeters associated with bright yellow discoloration of the skin of the upper and lower eyelids. Bilateral anterior cervical and submandibular lymph nodes were firm, immobile, and enlarged (see Figures 1 and 2).
Histopathology
A skin biopsy from one of the nodules demonstrated an unremarkable epidermis, and a monotonous cell population consisting of small blue lymphoid cells in the deep subcutaneous tissue. A sample of an inguinal lymph node demonstrated lack of a subcapsular sinus with pale areas effacing the normal architecture. A monotonous population of uniform small cells with pale to clear abundant cytoplasm and vesicular nuclei with prominent central nucleoli were present (see Figure 3). Immunohistochemical staining demonstrated positive staining for...