Contact and atopic eyelid dermatitis: Differential diagnosis and treatment
DOI:
https://doi.org/10.31288/Ukr.j.ophthalmol.202639198Keywords:
periocular inflammation, allergic conjunctivitis, patch testing, calcineurin inhibitors, glucocorticosteroids, allergen sensitisationAbstract
The aim of this study was to analyse the clinical features and treatment approaches for allergic conditions of the eyelids and periocular area, including contact and atopic dermatitis. The research was based on a comprehensive review of 45 recent publications from the last five years retrieved from PubMed, Scopus, Google Scholar, and the Cochrane Library, using bibliographic and bibliosemantic methods. Current therapeutic strategies are discussed, including topical corticosteroids, calcineurin inhibitors, systemic antihistamines, and advanced treatments such as biological agents (e.g., dupilumab) and allergen-specific immunotherapy. Special attention is paid to skin barrier restoration with emollients and the importance of allergen avoidance in long-term disease control. The diagnostic challenge of differentiating allergic contact dermatitis, atopic dermatitis, and irritant dermatitis of the eyelids is highlighted. Eyelid involvement may represent a manifestation of systemic atopic disease or result from hypersensitivity to external agents such as cosmetics, ophthalmic products, metals, fragrances, and preservatives. Patch testing remains the gold standard for identifying contact allergens, while atopy testing and serum IgE assessment have limited specificity. Overall, eyelid dermatitis requires an individualised, multidisciplinary approach combining modern pharmacological therapy with preventive strategies to improve clinical outcomes.
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