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Can Fam Physician. 2010 June; 56(6): 553.
PMCID: PMC2902943

Question: Can you identify this condition?

David S. Ehmann, Kelly Schweitzer, MD, and Sanjay Sharma, MD MBA MSc FRCSC
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A 60-year-old woman presented with a 1-day history of bleeding from the right eye; the bleeding began upon awakening and resolved 1 hour after onset. There were no other ocular symptoms. Her past ocular history was notable for bilateral blepharitis and recurrent chalazia in her right eye, which was treated by incision and curettage. She was otherwise healthy, and the rest of her medical history was unremarkable. Her visual acuity was 20/20 in both eyes. Visual fields, pupils, extraocular movements, intraocular pressure, and fundoscopy results were normal. No lesion was visible upon gross external examination; however, a red, beefy, pedunculated nodule protruded from the inferior palpebral conjunctiva of the right eye upon manual lower lid retraction.

The most likely diagnosis is

  1. Chalazion
  2. Squamous cell carcinoma
  3. Pyogenic granuloma
  4. Malignant melanoma

Answer on page 556

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