Allergic contact dermatitis to topical chloramphenicol: The role of patch testing

Chloramphenicol is commonly used in ophthalmology for its broad-spectrum antibacterial activity. However, it is a potential sensitizer and may cause allergic contact dermatitis (ACD), particularly with prolonged use. ACD affecting the eyelid and periocular area can mimic conjunctivitis or cellulitis, resulting in delayed diagnosis. We report a case of a 47-year-old male who developed severe periorbital dermatitis following the use of multiple topical ophthalmic preparations containing chloramphenicol. Patch testing with the medications “as is” revealed positive reactions to chloramphenicol-containing formulations and helped in early diagnosis and management.