The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.
The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

aCase 1

by Dr. Chua

This 15-year-old girl was referred from the endocrinology department because of these eyelid lesions and reduced vision. She suffered from hypopituitarism and renal failure of unknown cause. Her vision was CF (counting finger) in both eyes. Fundal examination revealed tilted discs and refractions showed moderate myopia of -3.00 but the vision remained poor at 6/60. Biopsy of the lesion revealed "horn cysts with keratinized centre surrounded by basophilic cells."  A CT scan was arranged but the patient developed sepsis and died before this could be done.

a. What is the most likely diagnosis for the skin lesion?

b. Is this condition inherited?

c. Is there an association between the skin lesions and her medical conditions?