Clinical Ophthalmology (Apr 2021)
Seven Common Allergen Groups Causing Eyelid Dermatitis: Education and Avoidance Strategies
Abstract
Crystal X Huang,1 James A Yiannias,2 Jill M Killian,3 Joanne F Shen4 1Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA; 2Department of Dermatology, Mayo Clinic, Scottsdale, AZ, USA; 3Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; 4Department of Ophthalmology, Mayo Clinic, Scottsdale, AZ, USACorrespondence: Joanne F Shen Tel +1 480-301-8085Fax +1 480-301-7326Email [email protected]: Eyelid dermatitis is most commonly attributed to allergic response. This retrospective clinical study identifies common allergens with eyelid involvement and addresses a literary gap by providing a clear approach for effective management of periorbital allergic contact dermatitis (ACD) recurrence.Methods: Charts of 215 patients diagnosed with periorbital dermatitis who were patch tested with Mayo Clinic Standard Series, Extended Standard Series, and personal products from 2013 to 2017 were examined. Positive reaction rates for patients with eyelid involvement were compared to those without. Findings were also compared to North American Contact Dermatitis Group (NACDG) 2013– 2014 and Mayo Clinic Contact Dermatitis Group (MCCDG) 2011– 2015 general patch test populations.Results: The 215 patients showed more common allergy to shellac, benzalkonium chloride, acrylates, and surfactants than the NACDG and MCCDG study populations. Periorbital ACD allergen groups eliciting the highest positive reaction rates were, in descending order: metals, shellac, preservatives, topical antibiotics, fragrances, acrylates, and surfactants. Of the corticosteroids, only tixocortol pivalate (the screening agent for prednisolone and fluorometholone) and budesonide elicited positive reactions.Conclusion: The top seven eyelid ACD allergen groups were identified. Avoidance of these allergens can be straightforward, with initial empiric counseling and free, online allergen avoidance programs. Patients who are unresponsive to avoidance should undergo patch testing.Keywords: allergic contact dermatitis, periorbital skin, patch test, contact allergens, allergen avoidance program
