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British Society for Cutaneous Allergy

CD01 Eyelid dermatitis revisited: an evaluation of 231 patch test patients over a 3-year period A. Lloyd-Lavery and S.M. Cooper Department of Dermatology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, U.K. The aetiology of eyelid dermatitis is variable and the differential is broad, including both allergic and irritant contact dermatitis, atopic dermatitis, seborrhoeic dermatitis and other conditions including psoriasis. The aim of our study was to investigate the prevalence of allergic contact dermatitis in patients presenting with eyelid dermatitis, and to compare our results with those of a similar study published by the senior author in 2000. We retrospectively reviewed our patch test data from January 2013 to December 2015 to establish the frequency of contact allergy and the final diagnoses made in patients with eyelid dermatitis. In total 1966 patients were patch tested during this period, of whom 231 had eyelid dermatitis. This included 196 female and 35 male patients in whom the mean age was 41 6 years (range 3 9–79 8). Overall 161 (69 7%) had only facial involvement and 70 (30 3%) also had involvement of other body sites. In total 151 (65 4%) had positive patch test results, with 115 (49 8%) thought to be currently relevant. Allergic contact dermatitis was diagnosed in 113 patients (48 9%); 103 were female and 10 were male. Of these patients, 28 (24 8%) had coexistent atopic dermatitis and three (2 7%) had coexistent irritant contact dermatitis. Allergic contact dermatitis was diagnosed in 92 patients (57 1%) with only facial involvement and in 21 (30%) with involvement of other body sites. A diagnosis of atopic dermatitis was made in 54 (23 4%) and irritant contact dermatitis in 27 (11 7%). Seborrhoeic dermatitis was diagnosed in five (2 2%). Only one patient was diagnosed with psoriasis. Of those with relevant positive patch test results, the most common allergens were limonene and/or linalool (in 33 patients), other fragrances (in 23 patients) and methylisothiazolinone and/or methylchloroisothiazolinone (in 30 patients). Our results indicate that allergic contact dermatitis is the major cause of eyelid dermatitis, and they broadly match recently published data. These figures are higher than those found in our previous study published in 2000, which may reflect the current ‘epidemic’ of methylisothiazolinone contact allergy and the fact that limonene and linalool are now included as part of the British Society for Cutaneous Allergy standard series. Female patients are consistently over-represented in the literature, with our results showing that female patients with eyelid dermatitis were more likely to be diagnosed with allergic contact dermatitis than male patients. Consistent with our results, fragrance allergy is the most commonly reported cause of relevant positive patch test results. We conclude that patch testing remains very relevant in the investigation of eyelid dermatitis.