Allergic Contact Dermatitis: a case series and review for the Ophthalmologist

Sharon Morris (1) , Richard Barlow (2) , Dinesh Selva (3) , Raman Malhotra (1)

1 Corneoplastic Unit, Queen Victoria Hospital
2 St John's Institute of Dermatology, St Thomas' Hospital
3 University of Adelaide

Eyelid dermatitis is most commonly caused by an allergenic response, potentially from exposure at another site, rather than from local toxicity. Yet allergic contact dermatitis (ACD) is a diagnosis often missed by ophthalmologists. We review the literature and detail our experience relating to the causes, clinical features and management of this condition. Fourteen patients over a 2-year period that were referred to the oculoplastic service for a further opinion, were reviewed in a retrospective, non-comparative study. All patients underwent patch-testing for diagnosis. Eight out of the fourteen patients had delays of greater than 6 months from symptoms to diagnosis. In six of these, this was greater than 1 year. Similar delays are reported in the literature. 79% of our cases were referred by ophthalmologists. Although two of our patients were biopsied, this did not help in making the diagnosis. 13 patients had disease restricted to the eyelids though only five of these had direct contact of the allergen with the eyelids. Two patients were also sensitized to topical steroid creams prescribed for their treatment. All patients improved after removal of the allergen. Further clinical features and management options from the literature are reviewed and discussed.

Mots clés: Eye Lids; Immunology; Inflammation; Diagnostic tests/Investigation

Sharon Morris, Richard Barlow, Dinesh Selva, Raman Malhotra. Allergic Contact Dermatitis: a case series and review for the Ophthalmologist. British Journal of Ophthalmology, 2010, 95 (7), pp.903. ⟨10.1136/bjo.2009.174607⟩. ⟨hal-00602288⟩