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Johannes Geier - One of the best experts on this subject based on the ideXlab platform.
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Periorbital Dermatitis in 4779 patients patch test results during a 10 year period
Contact Dermatitis, 2014Co-Authors: Lilla Landeck, Swen Malte John, Johannes GeierAbstract:Summary Background The thinness of the Periorbital skin may facilitate allergen penetration, making this area particularly susceptible to sensitization. Material and methods For the cross-sectional study, data were collected by the 57 participating centres of the Information Network of Departments of Dermatology. A total of 101 403 patients patch tested between January 2001 and December 2010 were included. Of these, 4779 patients suffered from Periorbital Dermatitis. Results Two major subgroups with different general epidemiological data and sensitization to specific allergens have to be considered: (i) young females with increased rates of skin atopy and allergies, particularly from cosmetic and skin care products; and (ii) older subjects with allergy to topical medications. The prevalence of sensitization to ophthalmic allergens is generally less than that to environmental allergens. Conclusions Allergic contact Dermatitis is a leading cause of Periorbital Dermatitis. Patch testing should be considered in all patients with Periorbital Dermatitis when contact allergy is suspected, in order to identify and avoid offending allergens.
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topical ophthalmic agents as allergens in Periorbital Dermatitis
British Journal of Ophthalmology, 2014Co-Authors: Lilla Landeck, Swen Malte John, Johannes GeierAbstract:Background Allergic contact Dermatitis is a leading cause of Periorbital Dermatitis. The extremely thin nature of the Periorbital skin may facilitate allergen penetration, making this area particularly susceptible to allergic contact sensitisation. In this study, we assessed sensitisation rates to ingredients of common topical ophthalmic agents. Materials and methods Data collected by 57 participating centres of the Information Network of Departments of Dermatology (IVDK) were analysed retrospectively. Of the 101 403 patients patch tested between January 2001 and December 2010, 4779 patients suffered from Periorbital Dermatitis and 1158 patients were specifically tested to the ophthalmic tray. Patch test results of the latter group were analysed in detail. Results The ophthalmic tray consisted of seven preservatives, six antibiotics and three other ophthalmic agents. Antibiotics (gentamicin, neomycin, kanamycin) were the leading group of allergens. Patch testing with preservatives often elicited irritant or weak positive reactions. Conclusions When suspecting contact allergy in the Periorbital area, patch testing should be considered in order to identify and avoid offending allergens. Testing to substances from a standardised ophthalmic tray is recommended, but it is preferable to test the actual drops or creams since many chemicals that are present in ophthalmics are not available as commercial test allergens. Given their wide use, preservatives cannot be regarded as common allergens, while antibiotics cause more often true allergic reactions necessitating a long-term avoidance.
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Periorbital Dermatitis in 4779 patients – patch test results during a 10‐year period
Contact Dermatitis, 2013Co-Authors: Lilla Landeck, Swen Malte John, Johannes GeierAbstract:Summary Background The thinness of the Periorbital skin may facilitate allergen penetration, making this area particularly susceptible to sensitization. Material and methods For the cross-sectional study, data were collected by the 57 participating centres of the Information Network of Departments of Dermatology. A total of 101 403 patients patch tested between January 2001 and December 2010 were included. Of these, 4779 patients suffered from Periorbital Dermatitis. Results Two major subgroups with different general epidemiological data and sensitization to specific allergens have to be considered: (i) young females with increased rates of skin atopy and allergies, particularly from cosmetic and skin care products; and (ii) older subjects with allergy to topical medications. The prevalence of sensitization to ophthalmic allergens is generally less than that to environmental allergens. Conclusions Allergic contact Dermatitis is a leading cause of Periorbital Dermatitis. Patch testing should be considered in all patients with Periorbital Dermatitis when contact allergy is suspected, in order to identify and avoid offending allergens.
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allergic and non allergic Periorbital Dermatitis patch test results of the information network of the departments of dermatology during a 5 year period
Contact Dermatitis, 2004Co-Authors: Rudolf A Herbst, Johannes Geier, Wolfgang Uter, Claudia Pirker, P J FroschAbstract:Periorbital Dermatitis is common and can be due to the external use of ophthalmic drugs. We evaluated patch test results of the Information Network of the Departments of Dermatology. During a 5-year period (1995–99), of a total 49 256 patch-tested patients, 1053 (2.1%) were eventually diagnosed as allergic Periorbital contact Dermatitis (APD) and 588 (1.2%) as non-allergic Periorbital Dermatitis (NAPD). Patient characteristics between APD, NAPD and other cases (OCs) differed with respect to sex (19.7% male in both Periorbital groups versus 36.3% in OCs), atopic Dermatitis (10.4% in APD versus 60.2% in NAPD versus 16.9% in OCs) and age, APD being substantially more often (68.2%) aged 40 and above than NAPD (52.6%). Several of the top allergens in OCs [such as fragrance mix, Myroxylon pereirae resin (balsam of Peru), lanolin alcohol and potassium dichromate] caused significantly fewer positive test reactions in both Periorbital groups. In contrast, thimerosal, phenylmercuric acetate, sodium disulfite, gentamicin sulfate, phenylephrine hydrochloride and benzalkonium chloride tested positively significantly more often in APD but not in NAPD, verifying them as true ophthalmic allergens. Finally, in 42 cases (4%) of APD patients, additional allergens were identified by testing of the patients' own substances (mostly β-blockers, oxybuprocaine and dexpanthenol), supporting the necessity of testing with ophthalmic drugs as is where individual substances are not readily available.
Lilla Landeck - One of the best experts on this subject based on the ideXlab platform.
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Periorbital Dermatitis in 4779 patients patch test results during a 10 year period
Contact Dermatitis, 2014Co-Authors: Lilla Landeck, Swen Malte John, Johannes GeierAbstract:Summary Background The thinness of the Periorbital skin may facilitate allergen penetration, making this area particularly susceptible to sensitization. Material and methods For the cross-sectional study, data were collected by the 57 participating centres of the Information Network of Departments of Dermatology. A total of 101 403 patients patch tested between January 2001 and December 2010 were included. Of these, 4779 patients suffered from Periorbital Dermatitis. Results Two major subgroups with different general epidemiological data and sensitization to specific allergens have to be considered: (i) young females with increased rates of skin atopy and allergies, particularly from cosmetic and skin care products; and (ii) older subjects with allergy to topical medications. The prevalence of sensitization to ophthalmic allergens is generally less than that to environmental allergens. Conclusions Allergic contact Dermatitis is a leading cause of Periorbital Dermatitis. Patch testing should be considered in all patients with Periorbital Dermatitis when contact allergy is suspected, in order to identify and avoid offending allergens.
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topical ophthalmic agents as allergens in Periorbital Dermatitis
British Journal of Ophthalmology, 2014Co-Authors: Lilla Landeck, Swen Malte John, Johannes GeierAbstract:Background Allergic contact Dermatitis is a leading cause of Periorbital Dermatitis. The extremely thin nature of the Periorbital skin may facilitate allergen penetration, making this area particularly susceptible to allergic contact sensitisation. In this study, we assessed sensitisation rates to ingredients of common topical ophthalmic agents. Materials and methods Data collected by 57 participating centres of the Information Network of Departments of Dermatology (IVDK) were analysed retrospectively. Of the 101 403 patients patch tested between January 2001 and December 2010, 4779 patients suffered from Periorbital Dermatitis and 1158 patients were specifically tested to the ophthalmic tray. Patch test results of the latter group were analysed in detail. Results The ophthalmic tray consisted of seven preservatives, six antibiotics and three other ophthalmic agents. Antibiotics (gentamicin, neomycin, kanamycin) were the leading group of allergens. Patch testing with preservatives often elicited irritant or weak positive reactions. Conclusions When suspecting contact allergy in the Periorbital area, patch testing should be considered in order to identify and avoid offending allergens. Testing to substances from a standardised ophthalmic tray is recommended, but it is preferable to test the actual drops or creams since many chemicals that are present in ophthalmics are not available as commercial test allergens. Given their wide use, preservatives cannot be regarded as common allergens, while antibiotics cause more often true allergic reactions necessitating a long-term avoidance.
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Periorbital Dermatitis in 4779 patients – patch test results during a 10‐year period
Contact Dermatitis, 2013Co-Authors: Lilla Landeck, Swen Malte John, Johannes GeierAbstract:Summary Background The thinness of the Periorbital skin may facilitate allergen penetration, making this area particularly susceptible to sensitization. Material and methods For the cross-sectional study, data were collected by the 57 participating centres of the Information Network of Departments of Dermatology. A total of 101 403 patients patch tested between January 2001 and December 2010 were included. Of these, 4779 patients suffered from Periorbital Dermatitis. Results Two major subgroups with different general epidemiological data and sensitization to specific allergens have to be considered: (i) young females with increased rates of skin atopy and allergies, particularly from cosmetic and skin care products; and (ii) older subjects with allergy to topical medications. The prevalence of sensitization to ophthalmic allergens is generally less than that to environmental allergens. Conclusions Allergic contact Dermatitis is a leading cause of Periorbital Dermatitis. Patch testing should be considered in all patients with Periorbital Dermatitis when contact allergy is suspected, in order to identify and avoid offending allergens.
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Periorbital Contact Sensitization
American Journal of Ophthalmology, 2010Co-Authors: Lilla Landeck, Peter C. Schalock, Lynn A. Baden, Ernesto GonzalezAbstract:Purpose To identify frequency and pattern of contact sensitization among patients with Periorbital Dermatitis. Design Cross-sectional retrospective investigation of 1247 patients referred for patch testing over a 17-year period. Methods Data were collected for patients undergoing patch testing to the standard and customized trays between January 1990 and December 2006 at the Massachusetts General Hospital, Contact Dermatitis Clinic. Our study group consisted of 266 patients affected by Periorbital Dermatitis. Findings were compared to 981 referrals without Periorbital Dermatitis (controls). Patch test results were read after 48 and 72 hours and classified as allergic, questionable, irritant, or negative. Statistical analyses were carried out by using χ 2 test and Fisher exact test. Results General epidemiologic data among Periorbital Dermatitis patients showed significant predominance of female gender (87.6%) and of individuals aged 40 to 59 years (45.9%). Nickel (16.5%) and fragrance mix (13.2%) were the top-ranking sensitizers. Ingredients of topical ophthalmologic products did not result in significant sensitization. Comparison of the Periorbital Dermatitis group to the controls did not reveal significant differences in sensitization pattern. Patch testing confirmed the likelihood of allergic contact Dermatitis in 50.8% of the Periorbital Dermatitis patients tested. Conclusions Allergic contact Dermatitis is a common cause of Periorbital Dermatitis. Patch testing should be considered in all patients with Periorbital Dermatitis when suspecting contact allergy in order to identify and avoid offending allergens.
Ivan Goldberg - One of the best experts on this subject based on the ideXlab platform.
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trabeculectomy trapdoor separation with allergic Periorbital Dermatitis an unusual late onset complication of guarded filtration surgery
Clinical and Experimental Ophthalmology, 2007Co-Authors: Paul A Adler, Ivan GoldbergAbstract:Hypotony post trabeculectomy may be the result of excessive aqueous outflow. Herein a case of an elderly man with excessive filtration 2 years post trabeculectomy resulting from trapdoor separation associated with allergic Periorbital Dermatitis is presented. Quaternary ammonium compounds are a significant cause of allergic Periorbital Dermatitis. Chronic rubbing associated with allergies to multiple topical quaternary ammonium compound-containing ophthalmic preparations is likely to have contributed to the trapdoor autotrauma and separation in this man with a background of allergic contact Dermatitis.
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Trabeculectomy trapdoor separation with allergic Periorbital Dermatitis: an unusual late‐onset complication of guarded filtration surgery
Clinical and Experimental Ophthalmology, 2007Co-Authors: Paul A Adler, Ivan GoldbergAbstract:Hypotony post trabeculectomy may be the result of excessive aqueous outflow. Herein a case of an elderly man with excessive filtration 2 years post trabeculectomy resulting from trapdoor separation associated with allergic Periorbital Dermatitis is presented. Quaternary ammonium compounds are a significant cause of allergic Periorbital Dermatitis. Chronic rubbing associated with allergies to multiple topical quaternary ammonium compound-containing ophthalmic preparations is likely to have contributed to the trapdoor autotrauma and separation in this man with a background of allergic contact Dermatitis.
Vera Mahler - One of the best experts on this subject based on the ideXlab platform.
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Periorbital Dermatitis causes differential diagnoses and therapy
Journal Der Deutschen Dermatologischen Gesellschaft, 2009Co-Authors: Alexandra Feser, Vera MahlerAbstract:Summary Periorbital Dermatitis is common and frequently difficult to treat. Patients with Periorbital Dermatitis often suffer severely because their disease is in such a visible location. Because of the variety of clinical appearance, the differential diagnostic considerations are often difficult. We examined the causes of Periorbital Dermatitis and compared the data of 88 patients from the Department of Dermatology, University Hospital Erlangen to those of the German IVDK (Information Network of the Departments of Dermatology). Between 1999 and 2004, predominant causes of Periorbital Dermatitis were allergic contact Dermatitis (Erlangen 44 %, IVDK 32 %), atopic eczema (Erlangen 25 %, IVDK 14 %), airborne contact Dermatitis (Erlangen 10 %, IVDK 2 %) and irritant contact Dermatitis (Erlangen 9 %, IVDK 8 %). Less frequent causes for secondary eczematous periocular skin lesions were Periorbital rosacea, allergic conjunctivitis or psoriasis vulgaris. Female gender, atopic skin diathesis and age of 40 years and older were identified as risk factors for periocular Dermatitis. Common elicitors of Periorbital allergic contact Dermatitis were leave-on cosmetic products (face cream, eye shadow) and eye drops with the usual allergens being fragrances, preservatives and drugs. Exact identification of relevant contact allergens and allergen elimination are essential for successful treatment. Calcineurin inhibitors are the first-line therapy for facial atopic eczema. They may be also effective in periocular eczematous lesions of other origins although they are not approved for such use.
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Periokuläre Ekzeme: Ursachen, Differenzialdiagnosen und Therapie
Journal Der Deutschen Dermatologischen Gesellschaft, 2009Co-Authors: Alexandra Feser, Vera MahlerAbstract:Summary Periorbital Dermatitis is common and frequently difficult to treat. Patients with Periorbital Dermatitis often suffer severely because their disease is in such a visible location. Because of the variety of clinical appearance, the differential diagnostic considerations are often difficult. We examined the causes of Periorbital Dermatitis and compared the data of 88 patients from the Department of Dermatology, University Hospital Erlangen to those of the German IVDK (Information Network of the Departments of Dermatology). Between 1999 and 2004, predominant causes of Periorbital Dermatitis were allergic contact Dermatitis (Erlangen 44 %, IVDK 32 %), atopic eczema (Erlangen 25 %, IVDK 14 %), airborne contact Dermatitis (Erlangen 10 %, IVDK 2 %) and irritant contact Dermatitis (Erlangen 9 %, IVDK 8 %). Less frequent causes for secondary eczematous periocular skin lesions were Periorbital rosacea, allergic conjunctivitis or psoriasis vulgaris. Female gender, atopic skin diathesis and age of 40 years and older were identified as risk factors for periocular Dermatitis. Common elicitors of Periorbital allergic contact Dermatitis were leave-on cosmetic products (face cream, eye shadow) and eye drops with the usual allergens being fragrances, preservatives and drugs. Exact identification of relevant contact allergens and allergen elimination are essential for successful treatment. Calcineurin inhibitors are the first-line therapy for facial atopic eczema. They may be also effective in periocular eczematous lesions of other origins although they are not approved for such use.
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Periorbital Dermatitis a recalcitrant disease causes and differential diagnoses
British Journal of Dermatology, 2008Co-Authors: Alexandra Feser, T Plaza, L Vogelgsang, Vera MahlerAbstract:Summary Background Periorbital Dermatitis is common and frequently recalcitrant to treatment. Due to the exposed and visible location, patients often suffer severely from Periorbital Dermatitis. Objectives To determine the frequency and causes of Periorbital Dermatitis including contact sensitizers. Methods We investigated two cohorts of patients (Erlangen and IVDK without Erlangen) between 1999 and 2004. Results The differences between the two cohorts with Periorbital Dermatitis [Department of Dermatology at University Hospital Erlangen (n = 88) and the German Information Network of Departments of Dermatology (IVDK) collective (n = 2035)] were determined by the MOAHLFA (male, occupational dermatosis, atopic eczema, hand Dermatitis, leg Dermatitis, facial Dermatitis, age ≥ 40 years) index. Statistically significant factors for periocular eczema are female sex, atopic skin diathesis and age ≥ 40 years. In both cohorts allergic contact Dermatitis was the main cause of Periorbital eczema (Erlangen 44·3%, IVDK 31·6%), followed by Periorbital atopic Dermatitis (Erlangen 25%, IVDK 14·1%), airborne Dermatitis (Erlangen 10·2%, IVDK 1·9%), irritant contact Dermatitis (Erlangen 9·1%, IVDK 7·6%), Periorbital rosacea (Erlangen 4·5%, IVDK 2·2%), allergic conjunctivitis (Erlangen 2·3%, IVDK included in ‘others’) and psoriasis (Erlangen 2·3%, IVDK included in ‘others’). The most relevant allergens/allergen sources inducing Periorbital eczema were consumers’ products (facial cream, eye shadow and ophthalmic therapeutics) (31%), fragrance mix (19%), balsam of Peru (10%), thiomersal (10%) and neomycin sulphate (8%); 12·5% of patients with allergic periocular Dermatitis could be exclusively elucidated by testing patients’ own products. Conclusions Our data demonstrate the multiplicity of causes for Periorbital eczematous disease manifestation, which requires patch testing of standard trays as well as consumers’ products to elucidate the relevant contact sensitization.
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Periorbital Dermatitis—a recalcitrant disease: causes and differential diagnoses
British Journal of Dermatology, 2008Co-Authors: Alexandra Feser, T Plaza, L Vogelgsang, Vera MahlerAbstract:Summary Background Periorbital Dermatitis is common and frequently recalcitrant to treatment. Due to the exposed and visible location, patients often suffer severely from Periorbital Dermatitis. Objectives To determine the frequency and causes of Periorbital Dermatitis including contact sensitizers. Methods We investigated two cohorts of patients (Erlangen and IVDK without Erlangen) between 1999 and 2004. Results The differences between the two cohorts with Periorbital Dermatitis [Department of Dermatology at University Hospital Erlangen (n = 88) and the German Information Network of Departments of Dermatology (IVDK) collective (n = 2035)] were determined by the MOAHLFA (male, occupational dermatosis, atopic eczema, hand Dermatitis, leg Dermatitis, facial Dermatitis, age ≥ 40 years) index. Statistically significant factors for periocular eczema are female sex, atopic skin diathesis and age ≥ 40 years. In both cohorts allergic contact Dermatitis was the main cause of Periorbital eczema (Erlangen 44·3%, IVDK 31·6%), followed by Periorbital atopic Dermatitis (Erlangen 25%, IVDK 14·1%), airborne Dermatitis (Erlangen 10·2%, IVDK 1·9%), irritant contact Dermatitis (Erlangen 9·1%, IVDK 7·6%), Periorbital rosacea (Erlangen 4·5%, IVDK 2·2%), allergic conjunctivitis (Erlangen 2·3%, IVDK included in ‘others’) and psoriasis (Erlangen 2·3%, IVDK included in ‘others’). The most relevant allergens/allergen sources inducing Periorbital eczema were consumers’ products (facial cream, eye shadow and ophthalmic therapeutics) (31%), fragrance mix (19%), balsam of Peru (10%), thiomersal (10%) and neomycin sulphate (8%); 12·5% of patients with allergic periocular Dermatitis could be exclusively elucidated by testing patients’ own products. Conclusions Our data demonstrate the multiplicity of causes for Periorbital eczematous disease manifestation, which requires patch testing of standard trays as well as consumers’ products to elucidate the relevant contact sensitization.
Rodríguez Na - One of the best experts on this subject based on the ideXlab platform.
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EYELID CONTACT ALLERGIC ECZEMA CAUSED BY TOPICAL KETOROLAC TROMETHAMINE 0.5% ECCEMA ALÉRGICO DE CONTACTO PALPEBRAL POR KETOROLACO TROMETAMOL 0,5% TÓPICO
2020Co-Authors: Rodríguez Na, Abarzuza R, Ja Cristobal, Sierra J, E Minguez, Del Buey MaAbstract:Clinical case: A 65-year-old man had been treated with eye-drops containing NSAIDs (Ketorolac). He developed conjunctival injection, edematous swelling of the eyelids and Periorbital Dermatitis due to a contact allergy. Allergy to NSAIDs is uncommon. Discussion: This is an unusual case because topical application of ketorolac is safe in the vast majority of ophthalmologic patients. However adverse events associated with Ketorolac are similar to that of other NSAIDs (Arch Soc Esp Oftalmol 2006; 81: 213-216).
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ECCEMA ALÉRGICO DE CONTACTO PALPEBRAL POR KETOROLACO TROMETAMOL 0,5% TÓPICO EYELID CONTACT ALLERGIC ECZEMA CAUSED BY TOPICAL KETOROLAC TROMETHAMINE 0.5%
2020Co-Authors: Rodríguez Na, Abarzuza R, Ja Cristobal, Sierra J, E Minguez, Del Buey MaAbstract:Clinical case: A 65-year-old man had been treated with eye-drops containing NSAIDs (Ketorolac). He developed conjunctival injection, edematous swelling of the eyelids and Periorbital Dermatitis due to a contact allergy. Allergy to NSAIDs is uncommon. Discussion: This is an unusual case because topical application of ketorolac is safe in the vast majority of ophthalmologic patients. However adverse events associated with Ketorolac are similar to that of other NSAIDs (Arch Soc Esp Oftalmol 2006; 81: 213-216).
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Eccema alérgico de contacto palpebral por ketorolaco trometamol 0,5% tópico
Archivos de la Sociedad Espanola de Oftalmologia, 2006Co-Authors: Rodríguez Na, Abarzuza R, Ja Cristobal, Sierra J, E Minguez, M.a. Del BueyAbstract:espanolCaso clinico: Hombre de 65 anos que habia sido tratado con AINE topico (Ketorolaco). El paciente presento inyeccion conjuntival, edema de parpados, y Dermatitis periorbitaria por eccema alergico de contacto secundario a AINE, un hecho raro en este tipo de tratamiento. Discusion: Este es un caso raro, ya que la aplicacion de Ketorolaco topico es seguro en la mayoria de los pacientes oftalmologicos. Ademas, las reacciones adversas asociadas con el Ketorolaco son similares a otros AINES. EnglishClinical case: A 65-year-old man had been treated with eye-drops containing NSAIDs (Ketorolac). He developed conjunctival injection, edematous swelling of the eyelids and Periorbital Dermatitis due to a contact allergy. Allergy to NSAIDs is uncommon. Discussion: This is an unusual case because topical application of ketorolac is safe in the vast majority of ophthalmologic patients. However adverse events associated with Ketorolac are similar to that of other NSAIDs.