Connective tissue nevi: A case report of a uniquely presenting eyelid collagenoma

While uncommon, benign connective tissue nevi including collagenomas can present as a single or rarely multiple facial lesion(s). Collagenomas can occur sporadically or as part of a genetic syndrome. Unique clinical presentations of collagenoma(s) may be a subtle indication of an underlying syndrome. Thus, the clinical features that are most important to assess on physical exam include the lesion focality (i.e., single vs. multi-focal), location of the lesion(s), and dermatologic configuration (i.e., papular or nodular vs. plaque-like vs. cerebriform etc.). Of note, while typically tan-pink in color on physical exam, collagenomas may be erythematous, as in our case, and can thus be mistaken for vascular lesions. Collagenomas are non-cystic in nature and thus from our experience do not appear to be amenable to surgical marsupialization. Lastly, if biopsy is pursued, an accurate diagnosis of collagenoma is important due to the aforementioned potential syndromic implications as well as a minimal though non-zero risk of recurrence.