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

Rémy Hamdan1, Cyrielle Chea2, Maxime Brisson2

  • 1Department of Vascular Medicine, Macon Hospital Centre, Mâcon, France.

SAGE Open Medical Case Reports
|February 28, 2025
PubMed
Summary

A rare case of neck cellulitis was linked to allergic contact dermatitis (CD) from nickel in spectacle frames. Prompt treatment involving antibiotics and avoiding metal eyewear led to full recovery, highlighting a novel cause for this infection.

Keywords:
Head-and-neck cellulitiscontact dermatitiseyeglassesnickel allergypatch testsspectacle frames

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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.