PURPOSE: We report the case of a patient with scar sarcoidosis that developed along a previous eyelid scar. There was no evidence of ocular or systemic sarcoidosis. METHODS: A 29-year-old man presented with a mass on his right eyelid that had been present for two month. On ocular examination an erythematous, firm, and non-tender mass was diffusely palpable along the upper and lower eyelid scar. We performed an incisional biopsy of the lower lid mass. RESULTS: Histopathologic examination of the mass revealed numerous, noncaseating granulomas with multi-nucleated giant cells. The giant cells contained asteroid bodies and calcium oxalate crystals characteristic of sarcoidosis, although the patient had no other evidence of systemic sarcoidosis. The mass in the upper lid disappeared after intralesional triamcinolone injections. CONCLUSIONS: This case represents a rare occurrence of sarcoidosis that arose in an old eyelid scar. Scar sarcoidosis should be considered in the differential diagnosis of an unusual mass in a scar.
Triamcinolone/administration & dosage ; Sarcoidosis/drug therapy/etiology/*pathology ; Male ; Injections, Intralesional ; Humans ; Glucocorticoids/administration & dosage ; Follow-Up Studies ; Eyelids/injuries ; Eyelid Diseases/drug therapy/etiology/*pathology ; Eye Injuries/complications ; Diagnosis, Differential ; Cicatrix/complications/*pathology ; Biopsy ; Adult

Primary lid tuberculosis after lid surgery is a very rare condition and is likely caused by the introduction of bacilli through epithelial injury. Secondary infection, due to direct hematogenous spread or contiguous spread from adjacent structures are more common presentations of lid tuberculosis. The authors experienced a case of primary lid tuberculosis occurring in a 19 year old female after blepharoplasty for making a eyelid crease. Her upper lid skin showed a reddish and non-tender mass lesion measured 3x1 cm, which was diagnosed as the tuberculosis through typical histopathological findings (caseous necrosis), acid-fast bacilli stain and PCR, and treated with anti-tuberculosis medications.
Adult ; Antitubercular Agents/therapeutic use ; Blepharoplasty/*adverse effects ; DNA, Bacterial/analysis ; Eyelid Diseases/drug therapy/*etiology ; Female ; Humans ; Mycobacterium tuberculosis/*isolation & purification ; Polymerase Chain Reaction ; Tomography, X-Ray Computed ; Treatment Outcome ; Tuberculosis, Ocular/drug therapy/*etiology