Periorbital Dermatitis Diagnosis and Treatment

Clinical Presentation and Diagnosis

Dennie-Morgan lines are present in 60-80% of atopic children, and "allergic shiners" are found in up to 60% of atopic patients, according to the American Academy of Allergy, Asthma, and Immunology 1
Medication-induced keratoconjunctivitis is characterized by contact dermatitis of eyelids with erythema and scaling, conjunctival follicles, and keratitis, most commonly caused by topical glaucoma medications, NSAIDs, antibiotics, antivirals, or preservatives, as reported by the American Academy of Ophthalmology 2
Allergic conjunctivitis often accompanies allergic rhinitis with itchy eyes and tearing, as noted by the American Academy of Allergy, Asthma, and Immunology 3, 4

Examine for primary vs. secondary lesions and scratch-induced changes, and look for Dennie-Morgan lines and allergic shiners suggesting atopic background, as recommended by the American Academy of Dermatology 1, 5
Assess for conjunctival involvement (injection, chemosis) suggesting allergic conjunctivitis, according to the American Academy of Allergy, Asthma, and Immunology 3, 4

Dupilumab-associated ocular surface disease may occur in patients on dupilumab for severe atopic dermatitis, characterized by bilateral injection with watery/mucous discharge, as reported by the American Academy of Ophthalmology 2
Emollients with high lipid content are recommended for maintaining skin hydration, as suggested by the American Academy of Dermatology 5