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Periorbital dermatitis--a recalcitrant disease: causes and differential diagnoses.
Br J Dermatol. 2008 Sep; 159(4):858-63.BJ

Abstract

BACKGROUND

Periorbital dermatitis is common and frequently recalcitrant to treatment. Due to the exposed and visible location, patients often suffer severely from periorbital dermatitis.

OBJECTIVES

To determine the frequency and causes of periorbital dermatitis including contact sensitizers.

METHODS

We investigated two cohorts of patients (Erlangen and IVDK without Erlangen) between 1999 and 2004.

RESULTS

The differences between the two cohorts with periorbital dermatitis [Department of Dermatology at University Hospital Erlangen (n = 88) and the German Information Network of Departments of Dermatology (IVDK) collective (n = 2035)] were determined by the MOAHLFA (male, occupational dermatosis, atopic eczema, hand dermatitis, leg dermatitis, facial dermatitis, age > or = 40 years) index. Statistically significant factors for periocular eczema are female sex, atopic skin diathesis and age > or = 40 years. In both cohorts allergic contact dermatitis was the main cause of periorbital eczema (Erlangen 44.3%, IVDK 31.6%), followed by periorbital atopic dermatitis (Erlangen 25%, IVDK 14.1%), airborne dermatitis (Erlangen 10.2%, IVDK 1.9%), irritant contact dermatitis (Erlangen 9.1%, IVDK 7.6%), periorbital rosacea (Erlangen 4.5%, IVDK 2.2%), allergic conjunctivitis (Erlangen 2.3%, IVDK included in 'others') and psoriasis (Erlangen 2.3%, IVDK included in 'others'). The most relevant allergens/allergen sources inducing periorbital eczema were consumers' products (facial cream, eye shadow and ophthalmic therapeutics) (31%), fragrance mix (19%), balsam of Peru (10%), thiomersal (10%) and neomycin sulphate (8%); 12.5% of patients with allergic periocular dermatitis could be exclusively elucidated by testing patients' own products.

CONCLUSIONS

Our data demonstrate the multiplicity of causes for periorbital eczematous disease manifestation, which requires patch testing of standard trays as well as consumers' products to elucidate the relevant contact sensitization.

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Authors+Show Affiliations

Feser A
Department of Dermatology, University Hospital Erlangen, Hautklinik, Hartmannstrasse 14, Erlangen, Bayern 91052, Germany. alexandra.feser@uk-erlangen.de
Plaza T
No affiliation info available
Vogelgsang L
No affiliation info available
Mahler V
No affiliation info available

MeSH

AdultAgedAged, 80 and overAllergensCohort StudiesCosmeticsDermatitis, Allergic ContactEyelid DiseasesFacial DermatosesFemaleGermanyHumansMaleMiddle AgedOphthalmic SolutionsPatch TestsPredictive Value of TestsSensitivity and SpecificitySex Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18721191

Citation

Feser, A, et al. "Periorbital Dermatitis--a Recalcitrant Disease: Causes and Differential Diagnoses." The British Journal of Dermatology, vol. 159, no. 4, 2008, pp. 858-63.
Feser A, Plaza T, Vogelgsang L, et al. Periorbital dermatitis--a recalcitrant disease: causes and differential diagnoses. Br J Dermatol. 2008;159(4):858-63.
Feser, A., Plaza, T., Vogelgsang, L., & Mahler, V. (2008). Periorbital dermatitis--a recalcitrant disease: causes and differential diagnoses. The British Journal of Dermatology, 159(4), 858-63. https://doi.org/10.1111/j.1365-2133.2008.08790.x
Feser A, et al. Periorbital Dermatitis--a Recalcitrant Disease: Causes and Differential Diagnoses. Br J Dermatol. 2008;159(4):858-63. PubMed PMID: 18721191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Periorbital dermatitis--a recalcitrant disease: causes and differential diagnoses. AU - Feser,A, AU - Plaza,T, AU - Vogelgsang,L, AU - Mahler,V, Y1 - 2008/08/21/ PY - 2008/8/30/pubmed PY - 2009/1/1/medline PY - 2008/8/30/entrez SP - 858 EP - 63 JF - The British journal of dermatology JO - Br J Dermatol VL - 159 IS - 4 N2 - BACKGROUND: Periorbital dermatitis is common and frequently recalcitrant to treatment. Due to the exposed and visible location, patients often suffer severely from periorbital dermatitis. OBJECTIVES: To determine the frequency and causes of periorbital dermatitis including contact sensitizers. METHODS: We investigated two cohorts of patients (Erlangen and IVDK without Erlangen) between 1999 and 2004. RESULTS: The differences between the two cohorts with periorbital dermatitis [Department of Dermatology at University Hospital Erlangen (n = 88) and the German Information Network of Departments of Dermatology (IVDK) collective (n = 2035)] were determined by the MOAHLFA (male, occupational dermatosis, atopic eczema, hand dermatitis, leg dermatitis, facial dermatitis, age > or = 40 years) index. Statistically significant factors for periocular eczema are female sex, atopic skin diathesis and age > or = 40 years. In both cohorts allergic contact dermatitis was the main cause of periorbital eczema (Erlangen 44.3%, IVDK 31.6%), followed by periorbital atopic dermatitis (Erlangen 25%, IVDK 14.1%), airborne dermatitis (Erlangen 10.2%, IVDK 1.9%), irritant contact dermatitis (Erlangen 9.1%, IVDK 7.6%), periorbital rosacea (Erlangen 4.5%, IVDK 2.2%), allergic conjunctivitis (Erlangen 2.3%, IVDK included in 'others') and psoriasis (Erlangen 2.3%, IVDK included in 'others'). The most relevant allergens/allergen sources inducing periorbital eczema were consumers' products (facial cream, eye shadow and ophthalmic therapeutics) (31%), fragrance mix (19%), balsam of Peru (10%), thiomersal (10%) and neomycin sulphate (8%); 12.5% of patients with allergic periocular dermatitis could be exclusively elucidated by testing patients' own products. CONCLUSIONS: Our data demonstrate the multiplicity of causes for periorbital eczematous disease manifestation, which requires patch testing of standard trays as well as consumers' products to elucidate the relevant contact sensitization. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/18721191/Periorbital_dermatitis__a_recalcitrant_disease:_causes_and_differential_diagnoses_ L2 - https://doi.org/10.1111/j.1365-2133.2008.08790.x DB - PRIME DP - Unbound Medicine ER -