Neck cellulitis complicating spectacle frames' contact dermatitis: A case report

Area of Science:

• Dermatology
• Infectious Diseases
• Ophthalmology

Background:

• Neck cellulitis typically stems from dental, pharyngeal, or ear infections, or trauma, with cutaneous entry points being rare.
• Contact dermatitis (CD) is an inflammatory skin condition often caused by delayed-type hypersensitivity reactions, frequently triggered by allergens like metals in eyeglasses.

Observation:

• A 34-year-old female presented with left-sided cervical cellulitis, limited head rotation, trismus, and a painful, oozing retroauricular contact dermatitis.
• Clinical examination confirmed cervical cellulitis superimposed on retroauricular CD; neck CT scans showed no abscess.
• Patch testing identified nickel sensitization as the likely cause of the allergic contact dermatitis.

Findings:

• The patient recovered completely after 8 days of systemic antibiotics targeting streptococci and staphylococci, coupled with topical care for the dermatitis and avoidance of metal eyeglass frames.
• This case suggests a novel pathway where allergic contact dermatitis from spectacle frames can lead to secondary skin infections and subsequent neck cellulitis.
• The study highlights the potential role of nickel allergy in spectacle frames as an uncommon etiology for retroauricular eczema and associated cervical infections.

Implications:

• Investigating spectacle frame contact dermatitis is crucial for patients presenting with retroauricular eczema, especially when accompanied by cervical cellulitis.
• This finding expands the differential diagnosis for neck cellulitis, suggesting dermatological triggers beyond typical infectious sources.
• Awareness of this link can improve diagnosis and management, preventing recurrence by identifying and removing the causative allergen.