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

Erin M. Warshaw, Lindsey M. Voller, Howard I. Maibach, Kathryn A. Zug, Joel G. DeKoven, Amber R. Atwater, Margo J. Reeder, Denis Sasseville, James S. Taylor, Joseph F. Fowler, Melanie D. Pratt, Jonathan I. Silverberg, Anthony F. Fransway, Matthew J. Zirwas, Donald V. Belsito, James G. Marks, Vincent A. DeLeo

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)953-964
Number of pages12
JournalJournal of the American Academy of Dermatology
Volume84
Issue number4
DOIs
StatePublished - Apr 2021

All Science Journal Classification (ASJC) codes

  • Dermatology

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