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What Are These Periorbital Changes?

What Are These Periorbital Changes?

FRS on periorbital area

A 72-year-old white man, previously employed as a truck driver, presented to the outpatient clinic for removal of nonmelanoma skin cancer from the tip of his nose.  The patient had a past medical history significant for basal cell carcinoma removed from his right upper chest. Patient was noted to have a painless, raised nodule with comedones exclusively on the left periorbital region (Figure 1A). The patient indicated the lesion was not new but rather present for many years and has slowly increased in size. He denied any other significant medical history or change in medications. Physical examination revealed unilateral left malar actinic skin, which was yellow in color and superimposed on multiple wrinkles in the left malar region, with multiple closed comedones. Right malar region had insignificant clinical findings (Figure 1B).

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