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Eyelid/ periorbital

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Eczematous skin changes on the eyelid(s) may be caused by allergic and irritant contact dermatitis including airborne contact dermatitis, atopic dermatitis and seborrhoeic dermatitis. Reddening of the eyelids is characteristic in hay fever, too. Common causes for allergic reactions are ingredients in cosmetic products (fragrances, balsam of Peru in creams, cobalt chloride in blue mascara), contact lense solutions (thiomersal, benzalconiumchlorid) nail polish (nickel) and hair spray (acrylates).

Clinical picture:

Erythema, oedema, scaling and possibly lichenification of the eyelids/ periorbital area are characteristic. In some cases, only oedema of the eyelids is present.

Diagnosis:

Careful history taking, clinical examination, Prick and patch testing are important diagnostic features to distinguish between an atopic, irritant or allergic etiology.

Differential diagnoses:

Disorders of the thyroid gland, dermatomyositis, nephropathies, erysipelas and angiooedema have to be taken into account. If only the eyelids are affected, causes of blepharitis e.g. rosacea are also possible differential diagnoses.



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