A malignant eyelid lesion

Features most consistent with a malignant eyelid lesion include:

  1. tenderness, erythema, alteration in pigment pattern
  2. disruption of tarsal architecture, raised pearly margins, pruritus
  3. lash loss, central ulceration, rapid growth
  4. ipsilateral lymph node metastasis, hyperkeratosis, dark pigmentation

explanation

Erythema, pruritus, and dark pigmentation are not associated with malignancy. Although most cancers have slow, progressive growth, rapid growth does not rule out a malignancy