A study investigating the causes of eyelid allergic dermatitis found a common correlation with glaucoma medications, topical cosmetics and skin care products. A short course of topical corticosteroids was effective as a treatment in most cases.
The study was based on a retrospective review of clinical records collected between 2002 and 2014. Sixty-one patients aged 33 to 94 years were diagnosed and treated for allergic dermatitis over this period of time. The majority were women. Symptoms at presentation were eyelid itching, tearing, redness, discharge, inflammation, malpositioning and conjunctival reaction.
The etiology of dermatitis was established after signs and symptoms disappeared upon discontinuation of potential causative agents. The three most common causes were topical glaucoma medications, skin lotions and cosmetics. Eye rubbing was also found to be a contributing factor in some cases. The treatment protocol included discontinuation of the suspected agent and the use of steroid ointment (mostly loteprednol etabonate) twice a day for 1 month. Complete resolution was achieved in 40 patients (65.6%) and partial resolution in 14 patients (23%). Eight patients with persistent signs and symptoms underwent patch testing. Four were found to be allergic to gold and recovered after they stopped wearing gold jewelry. Two were found to be allergic to fragrances and one to zinc, with all patients recovering after contact with the allergen was discontinued.
Patients with glaucoma were converted to other glaucoma medications, laser or surgery.
As the authors noted, allergic dermatitis is a common condition, often misdiagnosed or unrecognized, leading to inappropriate or delayed management. – by Michela Cimberle
Disclosure: The authors report no relevant financial disclosures.