Eyelid Dermatitis: A 5-Year Retrospective Review from a Metropolitan Contact Dermatitis Clinic

BACKGROUND: Allergic contact dermatitis is a common cause of eyelid dermatitis. OBJECTIVE: To identify the most common clinically relevant allergens and characterize personal product exposures in patients with eyelid dermatitis presenting for patch testing. METHODS: Retrospective study of 245 patients with eyelid dermatitis patch tested over a 5-year period. Reported data include demographics, history of atopy, and patch test reaction prevalence and relevance, including reactions to personal care products. RESULTS: 8.83% of patch-tested patients in our clinic presented with primary eyelid dermatitis (+/- head/neck involvement). Carmine, cetrimonium chloride, cocamidopropyl betaine-related surfactants (dimethylaminopropylamine, oleamidopropyl dimethylamine, and amidoamine), preservatives (methylisothiazolinone and formaldehyde), fragrances (Balsam of Peru and linalool), and nickel were the top 10 clinically relevant allergens. Shampoos and make-up were the most common personal products demonstrating reactions. Topical and ocular medicaments, acrylates, hairdressing chemicals, salicylates, and ultraviolet light filters were rare but relevant allergens. CONCLUSIONS: Patch testing continues to play an essential role in the diagnosis and management of eyelid dermatitis. Testing supplemental series as well as direct testing of patients' products is critical for the detection of clinically relevant allergens.