title: Identifying predictive morphologic  features of malignancy in eyelid lesions.
abstract: OBJECTIVE
  To determine features of eyelid lesions most predictive of malignancy, and to design a key to assist general practitioners in the triaging of such lesions.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Department of Ophthalmology at Queen’s University in Kingston, Ont.
  
  
  METHODS
  A total of 199 consecutive periocular lesions requiring biopsy or excision were included.
  
  
  METHODS
  First, potential features suggestive of malignancy for eyelid lesions were identified based on a survey sent to Canadian oculoplastic surgeons. The sensitivity, specificity, and odds ratios (ORs) of these features were then determined using 199 consecutive photographed eyelid lesions of patients who presented to the Department of Ophthalmology and underwent biopsy or excision. A triage key was then created based on the features with the highest ORs, and it was pilot-tested by a group of medical students.
  
  
  RESULTS
  Of the 199 lesions included, 161 (80.9%) were benign and 38 (19.1%) were malignant. The 3 features with the highest ORs in predicting malignancy were infiltration (OR = 18.2, P < .01), ulceration (OR = 14.7, P < .01), and loss of eyelashes (OR = 6.0, P < .01). The acronym LUI (loss of eyelashes, ulceration, infiltration) was created to assist in memory recall. After watching a video describing the LUI triage key, the mean total score of a group of medical students for correctly identifying malignant lesions increased from 46% to 70% (P < .001).
  
  
  CONCLUSIONS
  Differentiating benign from malignant eyelid lesions can be difficult even for experienced physicians. The LUI triage key provides physicians with an evidence-based, easy-to-remember system for assisting in the triaging of these lesions.
authors.forename: Christina
authors.initials: C
authors.lastname: Leung
authors.forename: Davin
authors.initials: D
authors.lastname: Johnson
authors.forename: Renee
authors.initials: R
authors.lastname: Pang
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kratky
mesh_terms: D001706:Biopsy; D055317:Evidence-Based Practice; D005140:Eyelashes / Q000254:growth & development; D005142:Eyelid Neoplasms / Q000473:pathology*; D005143:Eyelids / Q000473:pathology*; D006801:Humans; D016017:Odds Ratio; D009885:Ophthalmology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013337:Students, Medical; D063189:Symptom Assessment / Q000379:methods; D014218:Triage / Q000379:methods*