Basaloid follicular hamartoma of the eyelid in a pediatric p
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Basaloid follicular hamartoma (BFH) is a rare benign neoplasm arising from hair follicles. Clinically and histopathologically, BFH can resemble basal cell carcinomas and are associated with autoimmune disease. There are two reports of eyelid BFH, however, none in the pediatric population. We report a six-year-old girl with juvenile diabetes who presents with a flesh-colored papule of the eyelid harboring an aberrant eyelash found to be a basaloid follicular hamartoma.

A six-year-old Caucasian girl was referred for evaluation of a slowly progressive right upper eyelid lesion, which had developed over the prior two years. The lesion was neither painful nor pruritic. The patient denied a history of trauma or discharge. The patient's medical history included juvenile diabetes mellitus. Present on the right upper eyelid was a non-tender, flesh-colored papule measuring 1.5 × 1.0 mm with single white eyelash, approximately three times the length of the surrounding, normal lashes. There was no surrounding madarosis or eyelid distortion.

A gross total surgical excision of the lesion was performed. Histopathological analysis demonstrated proliferating anastomosing cords of the basaloid epithelium with variable peripheral palisading surrounded by a scant fibroblastic stroma consistent with basaloid follicular hamartoma (BFH). Four months postoperatively, there has been no recurrence. Given the rare potential of malignant transformation, complete surgical excision is recommended. As well, further monitoring for the development of autoimmune conditions should be considered as the child ages. Basaloid follicular hamartoma should be considered among the differential diagnosis of an eyelid lesion along the eyelash margin.