Lower eyelid reconstruction with tarsoconjunctival flap in a xeroderma pigmentosum patient

Xeroderma pigmentosum is an autosomal recessive genetic disorder of DNA repair in which the ability to repair damage caused by ultraviolet light is deficient. This disorder leads to multiple basal cell carcinomas and other skin malignancies at a young age. The eye is the second most commonly affected organ. We present a case of xeroderma pigmentosum with basal cell carcinoma totally infiltrating the lower eyelid. The reconstruction after excision has been planned with a tarsoconjunctival flap (modified Hughes procedure). This procedure had evolved over the years since it had been first described by Hughes. Some important modifications have led the flap to be used with much success. Our aim is to show that the tarsoconjunctival flap is a reliable option in the reconstruction of total lower eyelid defects, with good functional and esthetic outcomes.