Periocular dermatitis: a report of 401 patients

Area of Science:

• Dermatology
• Allergology
• Ophthalmology

Background:

• Periocular contact dermatitis (PD) presents as conjunctivitis, eyelid dermatitis, or both, often triggered by environmental or therapeutic allergens.
• Identifying specific contact allergens is crucial for managing PD and preventing symptom exacerbation.

Purpose of the Study:

• To identify the causative contact allergens in 401 patients diagnosed with periocular dermatitis (PD).
• To assess the prevalence of hypersensitivity to both environmental and ophthalmic allergens in PD patients.

Main Methods:

• Patch testing was performed on 401 patients using standard environmental contact allergen series.
• A subset of 133 patients was additionally tested with ophthalmic allergen series (Brial basic and supplementary).
• International testing guidelines were followed for accurate allergen identification.

Main Results:

• Contact hypersensitivity was confirmed in 34.4% of all PD patients.
• Highest hypersensitivity rates were observed in patients with PD alone (51.18%), PD with ophthalmic complaints (30.4%), and PD with atopic dermatitis (27.9%).
• Nickel sulfate, fragrance mix I, balsam of Peru, PPD, and thiomersal were the most frequent environmental sensitizers. Ophthalmic allergens showed lower hypersensitivity rates (6.7% in the tested subgroup).

Conclusions:

• Environmental contact allergens are the predominant triggers for periocular dermatitis.
• Nickel sulfate and fragrance mix I are significant allergens in PD patients.
• Hypersensitivity to ophthalmic allergens is less common but warrants consideration in specific cases.