Cicatricial Ectropion: A Complication of Systemic Fluorouracil

Anterior lamellar deficit ectropion management

“…Repair of lower eyelid ectropion should address all the contributing anatomical factors. The benefits of skin grafting or myocutaneous flaps are well recognised for treating the vertically shortened anterior lamella [3][4][5][6][7][8][9]. However, ectropion is generally associated with horizontal 'lid-globe disparity' (eyelid laxity) [1,7,8,11,13] and failure to address this factor effectively will lead to sub-optimal outcomes.…”

“…Either a free full-thickness skin graft (FTSG) (Fig. 1) or an upper to lower lid transpositional flap [3]-inlaid monopedicle myocutaneous flap (MMCF)-(Fig. 2) harvested from the upper lid is used when available.…”

Anterior lamellar deficit ectropion management

“…Repair of lower eyelid ectropion should address all the contributing anatomical factors. The benefits of skin grafting or myocutaneous flaps are well recognised for treating the vertically shortened anterior lamella [3][4][5][6][7][8][9]. However, ectropion is generally associated with horizontal 'lid-globe disparity' (eyelid laxity) [1,7,8,11,13] and failure to address this factor effectively will lead to sub-optimal outcomes.…”

“…Either a free full-thickness skin graft (FTSG) (Fig. 1) or an upper to lower lid transpositional flap [3]-inlaid monopedicle myocutaneous flap (MMCF)-(Fig. 2) harvested from the upper lid is used when available.…”

Capecitabine-induced bilateral ectropion: A rare ocular manifestation requiring surgical intervention

“…[1] Both topical and systemic uses of 5-FU were reported to be associated with the development of ectropion. [3456] Eiseman et al . [3] reported that ocular complications occur on an average of 3 months after the initiation of 5-FU therapy and may rarely result in permanent changes that do not resolve after therapy is discontinued as the refractory cicatricial ectropion rate was 1.9% in their study.…”

“…In addition to discontinuation of 5-FU, topical treatment with corticosteroids may be required. [1] As Hurwitz[5] mentioned in their case report of two subjects, ectropion resolved completely after twice-daily dexamethasone ointment therapy. Two of the four cases reported by Straus et al .…”

Cicatricial Ectropion With Topical 5% Fluorouracil Cream

“…Although uncomfortable and unsightly, predictable adverse effects such as redness, inflammation, erosions, or formation of ulcers are common and are considered a natural progression in the mechanism of action of 5-FU cream in treating sun-damaged skin. 5 To avoid any potentially permanent disfiguring ocular adverse events due to unintentional eye application during treatment with topical 5-FU cream, patients need to be repeatedly reminded of the importance of washing their hands thoroughly after each application. [2][3][4] In light of the transient symptoms reported, it is likely that these cases of lid retraction and cicatricial ectropion resulted from skin contraction and inflammation in the treatment zone near the eyelids but did not directly involve contact and irritation to the eyes themselves.…”

Anterior lamellar deficit ectropion management

“…Repair of lower eyelid ectropion should address all the contributing anatomical factors. The benefits of skin grafting or myocutaneous flaps are well recognised for treating the vertically shortened anterior lamella [3][4][5][6][7][8][9]. However, ectropion is generally associated with horizontal 'lid-globe disparity' (eyelid laxity) [1,7,8,11,13] and failure to address this factor effectively will lead to sub-optimal outcomes.…”

“…Either a free full-thickness skin graft (FTSG) (Fig. 1) or an upper to lower lid transpositional flap [3]-inlaid monopedicle myocutaneous flap (MMCF)-(Fig. 2) harvested from the upper lid is used when available.…”

Capecitabine-induced bilateral ectropion: A rare ocular manifestation requiring surgical intervention

“…[1] Both topical and systemic uses of 5-FU were reported to be associated with the development of ectropion. [3456] Eiseman et al . [3] reported that ocular complications occur on an average of 3 months after the initiation of 5-FU therapy and may rarely result in permanent changes that do not resolve after therapy is discontinued as the refractory cicatricial ectropion rate was 1.9% in their study.…”

“…In addition to discontinuation of 5-FU, topical treatment with corticosteroids may be required. [1] As Hurwitz[5] mentioned in their case report of two subjects, ectropion resolved completely after twice-daily dexamethasone ointment therapy. Two of the four cases reported by Straus et al .…”

Cicatricial Ectropion With Topical 5% Fluorouracil Cream

“…Although uncomfortable and unsightly, predictable adverse effects such as redness, inflammation, erosions, or formation of ulcers are common and are considered a natural progression in the mechanism of action of 5-FU cream in treating sun-damaged skin. 5 To avoid any potentially permanent disfiguring ocular adverse events due to unintentional eye application during treatment with topical 5-FU cream, patients need to be repeatedly reminded of the importance of washing their hands thoroughly after each application. [2][3][4] In light of the transient symptoms reported, it is likely that these cases of lid retraction and cicatricial ectropion resulted from skin contraction and inflammation in the treatment zone near the eyelids but did not directly involve contact and irritation to the eyes themselves.…”

Anterior lamellar deficit ectropion management

“…Repair of lower eyelid ectropion should address all the contributing anatomical factors. The benefits of skin grafting or myocutaneous flaps are well recognised for treating the vertically shortened anterior lamella [3][4][5][6][7][8][9]. However, ectropion is generally associated with horizontal 'lid-globe disparity' (eyelid laxity) [1,7,8,11,13] and failure to address this factor effectively will lead to sub-optimal outcomes.…”

“…Either a free full-thickness skin graft (FTSG) (Fig. 1) or an upper to lower lid transpositional flap [3]-inlaid monopedicle myocutaneous flap (MMCF)-(Fig. 2) harvested from the upper lid is used when available.…”

Capecitabine-induced bilateral ectropion: A rare ocular manifestation requiring surgical intervention

“…[1] Both topical and systemic uses of 5-FU were reported to be associated with the development of ectropion. [3456] Eiseman et al . [3] reported that ocular complications occur on an average of 3 months after the initiation of 5-FU therapy and may rarely result in permanent changes that do not resolve after therapy is discontinued as the refractory cicatricial ectropion rate was 1.9% in their study.…”

“…In addition to discontinuation of 5-FU, topical treatment with corticosteroids may be required. [1] As Hurwitz[5] mentioned in their case report of two subjects, ectropion resolved completely after twice-daily dexamethasone ointment therapy. Two of the four cases reported by Straus et al .…”

Cicatricial Ectropion With Topical 5% Fluorouracil Cream

“…Although uncomfortable and unsightly, predictable adverse effects such as redness, inflammation, erosions, or formation of ulcers are common and are considered a natural progression in the mechanism of action of 5-FU cream in treating sun-damaged skin. 5 To avoid any potentially permanent disfiguring ocular adverse events due to unintentional eye application during treatment with topical 5-FU cream, patients need to be repeatedly reminded of the importance of washing their hands thoroughly after each application. [2][3][4] In light of the transient symptoms reported, it is likely that these cases of lid retraction and cicatricial ectropion resulted from skin contraction and inflammation in the treatment zone near the eyelids but did not directly involve contact and irritation to the eyes themselves.…”