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The aim is to present a case of pilomatrixoma in the periocular area in a 10-year-old female through retrospective review of medical records of a single patient. A 10-year-old female developed a lesion under her right eyebrow over a period of one year. The rest of the ophthalmic history was unremarkable. On examination, oval, well-defined, subcutaneous tumor measuring 7 x 4 mm was found under the right eyebrow. It gave bluish tint under the firmly adherent overlying skin of normal color and texture. Rocky hard and non-tender, it was mobile over the underlying tissues. Total excision biopsy was performed under general anesthesia. Histopathologic analysis confirmed the diagnosis ofpilomatrixoma. Pilomatrixoma is a rare tumor with head, neck and periocular area being the commonest sites. It is often clinically misdiagnosed and/or missed on differential diagnosis. Although a benign tumor, malignant transformation into pilomatrix carcinoma has been described. Thus, total surgical excision of the mass is recommended.

Ectropion is a malposition of eyelid in which the eyelid is pulled away from the globe. It is classified in the following categories: congenital and acquired, which may be involutional, paralytic, cicatricial and mechanical. Depending on the etiology and the predominant location of ectropion, a variety of surgical techniques are available for its correction. In this retrospective study, 52 eyelids in 40 patients with lower eyelid ectropion were operatively treated at our Department during the 2005-2010 period. Involutional ectropion was present in 23 (44.2%), ectropion due to cicatricial changes in 13 (25.0%) and paralytic ectropion in 16 (30.8%) cases. The method of surgical repair was dependent on the underlying etiology and the predominant location of the ectropion. Surgical procedures for involutional entropion repair included pentagonal excision, Kuhnt-Symanowski type procedure, medial wedge excision, lazy-T procedure and lateral canthal sling. Cicatricial ectropion was treated with Z-plasty, local flaps, full-thickness skin graft, or their combination. Tarsorrhaphy and other surgical techniques for support and tightening of lower eyelid were used in paralytic ectropion repair. In 80% of patients, satisfactory functional and cosmetic outcome was achieved with a single surgical procedure. Eight (20%) patients with severe ectropion needed additional surgery. Ectropion repair presents a challenge in oculoplastic surgery. Therefore, individualized surgical approach based on adequate and thorough preoperative evaluation concerning the etiology and the predominant location of the ectropion is mandatory.