Eyelid dermatitis: an evaluation of 447 patients.
BACKGROUND
Eyelids can be affected by various types of dermatitis that are often difficult to diagnose.


OBJECTIVE
The aim of the study was to establish some guidelines for a correct diagnosis.


METHODS
A total of 447 patients treated at 12 research units for eczema or other inflammatory dermatitis located on the eyelids were invited to complete a questionnaire. When necessary, patch tests with haptens of the standard series from Gruppo Italiano di Ricerca sulle Dermatiti da Contatto e Ambientali della Società Italiana di Dermatologia e Venereologia (SIDEV-GIRDCA) were performed.


RESULTS
Of the subjects studied, 50.2 % were diagnosed with allergic contact dermatitis (ACD); 20.9% were affected by irritant contact dermatitis (ICD), 13.5% by atopic dermatitis, 6.3% by seborrheic dermatitis, 6.5% by aspecific xerotic dermatitis, and 2.3% by psoriasis. Approximately 91% of all subjects reported an absence of familial atopy. A significant statistical association between diagnosis type and a personal history of atopy was evident (p <.000001, chi-square test). The results of gradual logistic regression models showed four-eyelid involvement as the main risk factor for ACD (odds ratio [OR] = 3.0; 95% CI, 1.1-8.1); with ICD, the main risk factor was the onset of symptoms at between 2 and 6 months (OR = 2.1; 95% CI, 1.1-4.0), whereas for atopic dermatitis, the main risk factors were the onset of symptoms later than 6 months and a personal history of atopy (OR = 4.9 and 3.6, respectively).


CONCLUSIONS
Results suggest that many characteristics of the patients examined can be used for the differential diagnosis of palpebral eczematous dermatitis.
Ayala
Fabio
F
Dipartmento di Dermatologia, Università di Napoli Federico II, Naples, Italy. ayala@unina.it
Fabbrocini
Gabriella
G
Bacchilega
Roberto
R
Berardesca
Enzo
E
Caraffini
Stefano
S
Corazza
Monica
M
Flori
Maria Laura
ML
Francalanci
Stefano
S
Guarrera
Marcella
M
Lisi
Paolo
P
Santucci
Baldassarre
B
Schena
Donatella
D
Suppa
Francesco
F
Valsecchi
Rossano
R
Vincenzi
Colombina
C
Balato
Nicola
N
D000328:Adult; D000485:Allergens; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005143:Eyelids; D005148:Facial Dermatoses / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D010328:Patch Tests / Q000592:standards*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
D000485:Allergens