Benign eyelid tumours derived from hair follicles are rare and frequently misdiagnosed as basal-cell carcinoma when evaluation is based on clinical evidence alone. They include trichoepithelioma, trichofolliculoma, trichilemmoma, and pilomatrixoma. We reviewed 117 such tumours received in the Department of Pathology, Institute of Ophthalmology, London, in the last 30 years, a number which compared with 2447 basal-cell carcinomas seen over the same period. The hair follicle tumours may be safely excised with a narrow margin of clearance, whereas a macroscopic clearance of 3 to 5 mm or surgery with frozen section histological control is desirable for excision of basal-cell carcinoma. Therefore confirmation by incisional biopsy of the nature of any large lesion suspected of being a basal-cell carcinoma is essential in order to avoid performing an unnecessarily extensive or time consuming excision.
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