F/14; c/o oedema n pain since 3d. Spot Diagnosis please. I'm adding a similar image downloaded from net.




The key to the diagnosis is in pin head sized papules. If they existed for quite sometime b 4 oedema and erythema of lids think of " milia" theraputically assaulted by probably a keratoltic drug poularliy with one of steroid - salicylic acid preparation as much so it is iotrogenic and dermatitis medicamentosa. On the other hand if the pin headed lesions occured just a day b 4 or simutaniously.- they are pustules and thapicture is one of inflamatory in otigin. To be stye there should be a localised acte swelling outside (hardeolum externum or inside the lid ( H.internum ) it doesn't appear to be either. Bleharitis has matted eye lashes and margins per se r not that bad. Cellulitis of eye lid may be thinked twice b coz almost there is no subcutaneous tissue. It could not be more alarminhg cavernous sinus thrombosis or orbital crllulitis as there r no proptosis and chemosis of the eye So the local inflamation is localised to lid and in perticular to skin over the lid. Hence in my view , the possible diagnosis is " erisepalas" - a sreading cuticular lymphangitis due to streptococcal infection made posslble by micro abrasions of skin due to rubbing or scatching. The 2 DDcould not be settled to one diagnosis for want of data presented.

Acute blephritis

Skin infection of lid with multiple small pus pockets in skin with preseptal cellulitis .

Erysipelas like Infection of lid skin by hemolytic streptococci.

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Preseptal cellulitis




Stye leading to pre septal cellulitis


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