45 F .Came for itching only over eyelids two months. No h/o eye drops ,eyebrow liner , no make up. Didn't come in contact with insects. Ho habit of rubbing or wiping eyelids frequently. I probed along the line of contact dermatitis. Doesn't seem to fit. Opinion please.



Sir The picture clearly shows thickening and pigmentation of upper lids . There is h/o frequent rubbing of eyes. Pt had occular allegy probably to house dust (mite). Unless occular allergy is treated she won't stop rubbing the eyes and the problem persists. U can see the conjencti a after the pt rubs u will find redness. At least by a leading question u can definitely elicit such history. If occular allergy is ruled out by an opthalmologist- the cause of rubbing is a symptom of some nuroses. I bank on the former. Regarding derma problem- apply HC oint locally and give oral antihistaminic. Ref to opthalmolgist.

Valuable opinion

Allergic dermatitis of lids : Rx : * Tab dexamethasone 1 tid x 7 days , then 1 bid x 7 days , then 1 od x 7 days. *Tab . Avil 1 tid x 7 days , then 1 bid x 7 days. * Topical tobramycin with dexamethasone e/drops in tapering doses every week for 3 weeks. * Chloramphenicol with polymyxin with dexamethasone eye ointment on lid skin bid x 2 weeks. * Tab . Doxycycline 1 od x weeks.

Contact Dermatitis - allergic dust parthenium Advice - Patient should avoid rubbing the eyelids Frequent washing of face with very hot water if present should be avoided Treatment - Topical eye ointment containing a Steroid to be applied till the Itching is relieved Oral antihistamines

Allergic contact dermatitis

Allergic contact dermatitis

To rule out conjunctivitis, blepharitis. Dandruff, thyroid disorders. Zinc pyrithone and ketocanazole shampoo, olapatidine , cetrizine May be tried.

Cannot make out clearly however rule out pthriasis palpebrae and seb blepharitis as there are white specks along the lash line. The first one is managed by perlice scalp rinse and petroleum jelly application along eyelids and manual removal of lice. Seb blepharitis requires appropriate shampoo and regular oil application.

Seborrheic blepharitis

Tiny nodules perhaps are due to molluscum contagiosum

DENNIE MORGAN LINES..AD Saddle : Melasma.. Identify allergen do cbc esr stool urine HbA1c AEC IgE immediately... LUSH EYEBROWS -COSMETIC WORKUP...GIMMICKS....?

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