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. 2021 Apr;84(4):953-964.
doi: 10.1016/j.jaad.2020.07.020. Epub 2020 Jul 15.

Eyelid dermatitis in patients referred for patch testing: Retrospective analysis of North American Contact Dermatitis Group data, 1994-2016

Erin M Warshaw  1 , Lindsey M Voller  2 , Howard I Maibach  3 , Kathryn A Zug  4 , Joel G DeKoven  5 , Amber R Atwater  6 , Margo J Reeder  7 , Denis Sasseville  8 , James S Taylor  9 , Joseph F Fowler Jr  10 , Melanie D Pratt  11 , Jonathan I Silverberg  12 , Anthony F Fransway  13 , Matthew J Zirwas  14 , Donald V Belsito  15 , James G Marks Jr  16 , Vincent A DeLeo  17
Affiliations

Eyelid dermatitis in patients referred for patch testing: Retrospective analysis of North American Contact Dermatitis Group data, 1994-2016

Erin M Warshaw et al. J Am Acad Dermatol. 2021 Apr.

Abstract

Background: Eyelid dermatitis is a common dermatologic complaint.

Objective: To characterize patients with eyelid dermatitis.

Methods: Retrospective analysis (1994-2016) of North American Contact Dermatitis Group data.

Results: Of 50,795 patients, 2332 (4.6%) had eyelid dermatitis only, whereas 1623 (3.2%) also had dermatitis of the eyelids and head or neck. Compared with patients without eyelid involvement (n = 26,130), groups with eyelid dermatitis only and dermatitis of the eyelid and head or neck were significantly more likely to be female, white, and older than 40 years, and to have a history of hay fever, atopic dermatitis, or both (P < .01). Final primary diagnoses included allergic contact dermatitis (eyelid dermatitis only: 43.4%; dermatitis of the eyelid and head or neck: 53.5%), irritant contact dermatitis (eyelid dermatitis only: 17.0%; dermatitis of the eyelid and head or neck: 9.8%), and atopic dermatitis (eyelid dermatitis only: 13.1%; dermatitis of the eyelid and head or neck: 13.8%). Top 5 currently relevant allergens included nickel sulfate (eyelid dermatitis only: 18.6%; dermatitis of the eyelid and head or neck: 22.5%), fragrance mix I (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 18.3%), methylisothiazolinone (eyelid dermatitis only: 16.5%; dermatitis of the eyelid and head or neck: 17.7%), gold sodium thiosulfate (eyelid dermatitis only: 14.7%; dermatitis of the eyelid and head or neck: 11.4%), and balsam of Peru (eyelid dermatitis only: 11.9%; dermatitis of the eyelid and head or neck: 12.6%). Both eyelid-involvement groups were significantly more likely to react to gold sodium thiosulfate, carmine, shellac, dimethylaminopropylamine, oleamidopropyl dimethylamine, and thimerosal (P < .05) compared with the no eyelid involvement group.

Limitations: Lack of specific distribution patterns of eyelid dermatitis and no long-term follow-up data.

Conclusion: Patch testing remains a critical tool in evaluating patients with eyelid dermatitis.

Keywords: allergic contact dermatitis; contact allergy; eyelid dermatitis; eyelids; irritant contact dermatitis.

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