Microbial profile of lacrimal system Dacryoliths in American Midwest patient population.

PURPOSE: Dacryoliths of the canalicular pathway are classically attributed to Actinomyces species as the most common organism. However, global shifts toward Streptococcus and Staphylococcus species have been reported. The objective of this article is to update the American Midwest epidemiology of lacrimal system dacryoliths for targeted clinical treatment. MATERIALS AND METHODS: A retrospective chart review from January 2015 to 2021 of patients with a history of surgical procedure for lacrimal removal of dacryolith for canaliculitis, canalicular obstruction, dacryocystitis, and nasolacrimal duct obstruction was included. Specimens were sent for histopathological evaluation and microbial culture. RESULTS: A total of 48 specimens were included. The most common organism isolated for canalicular pathology was Actinomyces spp (23%), followed by Staphylococcus spp (21%) and Streptococcus spp (19%). Histopathological staining accounted for 45% of Actinomyces isolation when culture data inconclusive. In a subgroup analysis of lacrimal sac dacryoliths, the most common organism was Staphylococcus spp (29%). Actinomyces species were not isolated from the lacrimal sac or nasolacrimal duct. CONCLUSION: Actinomyces maintains a microbial predominance in canalicular dacryoliths and requires careful culture and histopathological analysis for its fastidious nature. Lacrimal sac and nasolacrimal duct dacryolith found no isolates of Actinomyces, and the most common organism was Staphylococcus.

Trichoadenoma of an eyelid in an adult mimicking sebaceous cell carcinoma.

The purpose of this report is to detail the clinical and histologic findings of a rare trichoadenoma of the eyelid. A 63-year-old male with a recurrent left lower eyelid lesion underwent a shave biopsy with inconclusive results until referred to an oculoplastic surgeon. The patient presented with a lesion suspicious for sebaceous cell carcinoma of the eyelid. An excisional biopsy was performed, and the specimen was sent for permanent section histologic analysis. The results revealed the lesion to be a trichoadenoma of the eyelid. The remaining lesion was excised, and the lower eyelid was reconstructed.