Demographic and Clinical Characteristics of Patients with Eyelid Eczema in a Referral Center from 2004 to 2018

Eyelid eczema have many etiologies, among them contact dermatitis.The investigation of suspect cases includes patients’ history, clinical examination, and patch tests. The goals of this study were: to determine demographical and clinical characteristics of patients with eyelid eczema patch tested between 2004 and 2018; to determine established diagnoses; and to identify responsible allergens. Medical records of patients with eyelid eczema who underwent patch testing were analyzed. This study included 228 patients, of which 89.5% were women, with a mean age of 45 years. Regarding clinical condition, 64.5% presented eczema lesions in other body parts besides the eyelids, mainly in other facial sites (51.8%). Final diagnosis was allergic contact dermatitis (ACD) in 61%, atopic dermatitis (AD) in 12.7%, undefined in 12.3%, irritant contact dermatitis in 7.9%, superimposing of ACD and AD in 3.1%, and other diagnoses in 3.1% of patients. Regarding patch tests, 64.4% of patients had at least one relevant positive allergen, the majorones being: toluene-sulfonamide-formaldehyde resin, paraphenylenediamine, nickel sulfate, fragrance mix I, neomycin, and Kathon CG. As main etiologies in ACD cases, nail polish (36%), topical medicaments (27.2%), non-specified cosmetics (24.5%), hair dye (13.6%), metals (15.6%), rubber (6.8%), and shampoos (4%) could be identified. Thereby, results presented compatibility to data in the literature: predominance of women and most prevalent final diagnosis of cosmetic-related ACD. Thus, when dealing with patients with eyelid eczema, investigation with patch testing is fundamental.