Inverted Follicular Keratosis of the Lower Eyelid: A Diagnostic Conundrum

September 2025 in “ Annals of Plastic Surgery ”

Harshavardhan Shetty, Joseph Thomas, Kanthilatha Pai, Anuradha Calicut Kini Rao, T.S. Chandrasekhara Rao, Premal A. Patel, Swathi Prabhu

inverted follicular keratosis squamous cell carcinoma histopathological examination endophytic growth pattern cellular atypia

TLDR Inverted follicular keratosis on the eyelid can be cured with surgery and has a great prognosis.

Inverted follicular keratosis (IFK) is a rare benign tumor that can resemble squamous cell carcinoma (SCC), making accurate diagnosis crucial to prevent overtreatment. This case study describes a 76-year-old male with a 20-year history of a nodular ulcerative lesion on the right lower eyelid, which was successfully treated with surgical excision. Histopathological examination confirmed IFK, characterized by an endophytic growth pattern and absence of cellular atypia. The study highlights that complete surgical excision of IFK is curative and has an excellent prognosis.

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Inverted Follicular Keratosis of the Lower Eyelid: A Diagnostic Conundrum

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