Allergic contact dermatitis can be manifest as an eruption confined to the eyelids. In regard to this specific presentation, only limited information on which to base the selection of patch tests for proper evaluation is available.
To identify the contact allergens most frequently found to be both patch test positive and relevant when only the eyelids are involved.
Data collected from 2003 to 2004 by the North American Contact Dermatitis Group (NACDG) were analyzed for relevant allergens in the setting of dermatitis on the eyelids only. Data on eyelid dermatitis patients whose relevant allergens were not among the 65 allergens used for screening during this study period were also tabulated.
Data showed that 268 patients had only eyelid dermatitis and a final diagnosis of allergic contact dermatitis. In 193 (72%) of these, reactions were of current relevance and were identified from a screening series of 65 allergens. The top 26 allergens identified 65% of cases (175 cases). Gold was the most frequently encountered allergen (22 of 175 cases [12.5%]). Of the 268 cases, 33 showed relevant reactions to an allergen that was not among the 65 NACDG standard screening allergens. No specific allergen was identified in the remaining 42 cases.
The top 26 allergens identified in this study represent a potential eyelid dermatitis screening series.
From the Southern Arizona VA Health Care System, Tucson, AZ; Minneapolis VAMC, Minneapolis, MN, University of Louisville, Louisville, KY, St. Luke's Roosevelt Hospital Center, New York, NY; University of Missouri, Kansas City, MO; Cleveland Clinic, Cleveland, OH, Oregon Health Science University, Portland, OR; University of California San Francisco, San Francisco, CA; Milton S. Hershey Medical Center, Hershey, PA, and Dartmouth-Hitchcock Medical Center, Lebanon, NH.
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