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Friday, February 26, 2016

A 30 Year Old Woman Presented With A Tender Nodule On Her Upper Eyelid

A 30-year-old woman presented with a tender nodule on the upper eyelid along with crusting and erythema to both eyelids. The image is shown below:


The condition was diagnosed as an external hordeolum.
The physician recommended that she apply warm moist compresses to her eyelids 4 times a day. Her hordeola resolved within 7 days.

Case Discussion:

Introduction: A hordeolum is an acute painful infection of the glands of the eyelid, usually caused by bacteria. Hordeola can be located on the internal or external eyelid. Internal hordeola that do not completely resolve become cysts called chalazia. External hordeola are commonly known as styes.


Etiology: 
Infection in the meibomian gland causes internal hordeolum, often resolves into a chalazion.
Infection in the Zeiss or Moll gland causes external hordeolum
• Staphylococcus aureus is the causative agent in most cases.

Hordeolum Versus Chalazion;

  • Chalazion is a nontender nodule on the eyelid.
  • In case of Hordeolum tenderness and erythema are localized to a point on the eyelid and conjunctival injection may be present.
Differential Diagnosis:
• Hidrocystoma—Benign cystic lesion that grows on the edge of the eyelids and is filled with clear fluid .
• Xanthelasma—Yellowish plaques, generally near medial canthus.
• Molluscum contagiosum—Waxy nodules with central umbilication; generally multiple.
• Sebaceous cell carcinoma—Rare cancer seen in middle-age and elderly patients; difficult to distinguish from recurrent chalazion or unilateral chronic blepharitis without biopsy.
• Basal cell carcinoma—Pearly nodule, often with telangiectasias or central ulceration; more common on lower medial eyelid

Management: 
~ Warm soaks, 3 to 4 times a day for 15 minutes, will elicit drainage in most cases.
~ Topical antibiotics (e.g., bacitracin ophthalmic ointment) may be beneficial for recurrent or spontaneously draining hordeolum.
~ Cases that do not respond to warm soaks or that are extremely painful and swollen may be incised and drained with a small incision.
~Systemic antibiotics are usually not needed unless patient has preseptal cellulitis.
~ Chalazion can be treated conservatively with lid hygiene and warm compresses. Warm compresses can be applied 2 to 3 times daily but may take weeks to months to work.

4 comments:

  1. Hello, my name is Betty. i was diagnosed of HIV virus 4 years back. Before then, i was dating this Derrick guy. we had something great going on. Our love life only lasted for 8 months. the sixth and seven month of our relationship, i began feeling very weak every now and then. But i never suspected anything until I kept on experiencing different symptoms like having sore throats, constant headache, body weakness e.t.c. I decided to go for a medical check up. I was tested HIV positive. when the doctor broke the news to me, it was as if my whole world had crumbled. it dawned on me then that Derrick has been lying to me. i was very mad to an extent i almost committed suicide. But there was nothing i could do, other than weep and weep. ever since then, i have been spending heavily on medications, going from one medical clinic or the other so I can look healthy. Though since i was a kid, i love herbs a lot. i take herbal tea with grandma while growing so i am quite familiar with herbs. early last year, i was on the internet and on a particular health blog, to check for herbal medication as alternative. I saw many comments and read many testimonies. Until i came across a particular testimony on how Dr.ugo cured a patient from herpes simplex virus using pure natural herbs. i reached out to the doctor because I also was thinking Herpes had no cure. I told him about my HIV status.He encouraged me not to panic that he will help me get my deliverance. he prepared some herbs and sent them to me. The herbs were in four 70ml bottles and I took them morning and night. i used as he directed, and in less than three weeks, i started having appetite to eat plenty of food and i gained back my strength. the fourth week,I consumed all the herbal meds. He encouraged me to go for a test which i did. This time, the result was negative. I quickly contacted the doctor and informed him of the news. I immediately asked him to prepare for Derrick too. He did and sent it. Today, me and Derrick are HIV free. All thanks goes to God Almighty for healing us through Dr.Ugo. if you are having any kind of sickness at all, Dr.Ugo is the right person to talk to and i assure you, you will be glad you did. His email: ugoherbalhome@gmail.com you can also write him on WhatsApp +2348104990619.

    ReplyDelete
  2. Nice blog
    Have been totally convinced that HIV,and many others dangerous diseases can be best cured using the Herbal Medicine. Dr.Akpu the great and powerful herbalist cured me with his Herbal remedy. I'm Linda,15 years from Texas. I was born with HIV. I lost parents at my teenager age when I was 4th. I had to grew up with my mum only Sister, whom I loved so much. She was so worried about my life as my condition was her mature problem in life. I had taken lots of antiviral treatment to get ride of the virus not believing what there said HIV has no cure. I was on the internet when i came across blogs of testimony about a lady who where cured of a 7 years diagnose of Herpes by this powerful Herbalist, Dr.Akpu.I wrote down his mail @ Dr.akpupowerherbscenter@gmail.com
    I told my Aunt,luckily it was the same Dr,we where referred to few months back by my pastor in church whom members have being testifying about of his cure We did contacted him and explained my problem to him.He prepared the medicine and sent to me with details of how to use and apply. After a while, I began to feel more strong than never before, I felt so lucky and happy when my Doctor congratulated me that he could found no HIV virus again in me. I knew I was free cos my body was so strong. His herbal medicine should have saved my parents life, i said!
    Thanks so much for reading my article, you should share your testimony if you have cure as well
    Dr.akpupowerherbscenter@gmail.com
    Is the solution

    ReplyDelete
  3. FINALLY FREE FROM HERPES VIRUS
    I thought my life had nothing to offer anymore because life
    became meaningless to me because I had Herpes virus, the
    symptoms became very severe and bold and made my family
    run from and abandoned me so they won't get infected. I gave
    up everything, my hope, dreams,vision and job because the
    doctor told me there's no cure. I consumed so many drugs but
    they never cured me but hid the symptoms inside me making
    it worse. I was doing some research online someday when I
    came across testimonies of some people of how DR Ebhota
    cured them from Herpes, I never believed at first and thought
    it was a joke but later decided to contact him on the details
    provided and when I messaged him we talked and he sent me
    his herbal medicine and told me to go for a test after two
    weeks. Within 7 days of medication the symptoms
    disappeared and when I went for a test Lo and behold I was
    NEGATIVE by the Doctor Who tested me earlier. Thank you DR
    Ebhota because I forever owe you my life and I'll keep on
    telling the world about you. If you are going through same
    situation worry no more and contact DR Ebhota via
    drebhotasolution@gmail. com or WhatsApp him via +2348089535482.
    he also special on cureing 1. HIV/AIDS2. HERPES 3. CANCER 4.
    ALS 5. HEPATITIS B 6.DIABETES 7. HUMAN PAPILOMA VIRUS DISEASE(HPV)8.
    ALZHEIMER 9. LUPUS (Lupus Vulgaris or LupusErythematosus

    ReplyDelete
  4. FINALLY FREE FROM HERPES VIRUS
    I thought my life had nothing to offer anymore because life
    became meaningless to me because I had Herpes virus, the
    symptoms became very severe and bold and made my family
    run from and abandoned me so they won't get infected. I gave
    up everything, my hope, dreams,vision and job because the
    doctor told me there's no cure. I consumed so many drugs but
    they never cured me but hid the symptoms inside me making
    it worse. I was doing some research online someday when I
    came across testimonies of some people of how DR Ebhota
    cured them from Herpes, I never believed at first and thought
    it was a joke but later decided to contact him on the details
    provided and when I messaged him we talked and he sent me
    his herbal medicine and told me to go for a test after two
    weeks. Within 7 days of medication the symptoms
    disappeared and when I went for a test Lo and behold I was
    NEGATIVE by the Doctor Who tested me earlier. Thank you DR
    Ebhota because I forever owe you my life and I'll keep on
    telling the world about you. If you are going through same
    situation worry no more and contact DR Ebhota via
    drebhotasolution@gmail. com or WhatsApp him via +2348089535482.
    he also special on cureing 1. HIV/AIDS2. HERPES 3. CANCER 4.
    ALS 5. HEPATITIS B 6.DIABETES 7. HUMAN PAPILOMA VIRUS DISEASE(HPV)8.
    ALZHEIMER 9. LUPUS (Lupus Vulgaris or LupusErythematosus

    ReplyDelete