Eyelid dermatitis atopic H01.1

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 26.02.2021

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Atopic Blepharitis; atopic eyelid eczema.; Atopic eyelid eczema; blepharitis atopica; Lid eczema atopic

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Localized minus variant of a topically limited atopic eczema. Atopic eyelid eczema may also occur as a co-participation of the eyelids in the context of extensive atopic eczema.

Clinical features
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Atopic eyelid eczema may present as acute, subacute or (frequently) as chronic eczematous inflammation of the eyelids. The eczema situation is essentially characterized by the special anatomical condition (moist chamber condition due to folds of the eyelids lying on top of each other with reservoir character for toxic or allergenic substances) and the special functionality of the eyelid organ.

In the foreground of the clinical symptoms is an unpleasant, pemanent or intermittent itching. The itching leads to constant rubbing of the eyelids with fingers or the back of the hand. Recurrent conjunctivitis is often the result of mechanical irritation of the eyelids. Atopic eyelid eczema may heal at any time; however, it may progress to an eminently chronic eczema reaction. The consequences are redness, scaling, possibly crusting, permanent thickening of the eyelids and eyelid margins with breaking off and doubling of the eyelash rows (distichiasis: see figure). This process is not infrequently associated with a change in the direction of growth of the eyelashes. Inward rotation of the eyelashes and eyelids leads to constant chafing effects on the conjunctiva and cornea with consecutive irritation syndrome of the eye (trichiasis). Not uncommon are ulcers of the cornea with subsequent scarring and loss of visual acuity.

General therapy
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The treatment of trichiasis belongs in the hands of the ophthalmologist. Individual turned in eyelashes can be epilated. In case of multiple lashes, an eradication of the pathological lash line is absolutely necessary.

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For further clinical, pathogenetic and therapeutic details see below.:


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Last updated on: 26.02.2021