PubMed ID: 22246332
Author(s): Groehler JM, Rose JG. Madarosis as an indicator for malignancy in eyelid margin lesions. Optom Vis Sci. 2012 Mar;89(3):350-2. doi: 10.1097/OPX.0b013e31824352b6. PMID 22246332
Journal: Optometry And Vision Science : Official Publication Of The American Academy Of Optometry, Volume 89, Issue 3, Mar 2012
PURPOSE The purpose of this study was to determine the sensitivity of madarosis as an indicator for malignancy in eyelid lesions affecting the lid margin.
METHODS A retrospective medical record review was completed for patients who were diagnosed with lesions affecting the eyelid margin which were suspicious for malignancy. Suspicion was determined by considering an array of factors, including lesion characteristics, Fitzpatrick score, sun exposure history, and history of skin cancer. Presence of madarosis was assessed by clinical examination, and presence of malignancy was determined by biopsy.
RESULTS The association between madarosis and malignancy was statistically significant (p ≤ 0.001). Madarosis had a sensitivity of 0.643 and a specificity of 0.882 when used as a sole indicator for malignancy. The odds of malignancy were 13.4 times higher in the presence of madarosis.
CONCLUSIONS Madarosis is more common in malignant eyelid margin lesions than benign lesions. If madarosis is present, there is a 69.23% chance that the lesion is malignant. Therefore, biopsy of any suspicious lesion that demonstrates madarosis is recommended. However, many malignant eyelid margin lesions do not demonstrate madarosis, and so the sensitivity of madarosis as a sole indicator for malignancy is poor. In the absence of madarosis, it is important to consider other factors when determining malignant potential of eyelid lesions.