Eyelids and Periorbital Area

Eyelids and Periorbital Area


Besides being subject to various inflammatory dermatoses such as atopic dermatitis, contact dermatitis, seborrheic dermatitis, and rosacea, the skin of the eyelids and the surrounding periorbital area is repeatedly exposed to the environment. The sun, the application of makeup, airborne substances (pollens, fragrance sprays), fingernail and toenail products that come in contact with the eyelids, and contact lenses, all have aggravating and allergenic potential in this area.

The eyelids readily swell and become edematous from internal complications, such as urticaria (angioedema). The eyelids and periorbital region may also serve as cutaneous signs of systemic conditions, such as indicators of hyperlipidemia (xanthelasma) and dermatomyositis (heliotrope sign). In addition, various benign and malignant neoplasms are seen here.


Atopic Dermatitis

Distinguishing Features

  • Habitual rubbing results in lichenification (exaggerated skin lines)

  • Dennie-Morgan folds are characteristic double creases that extend from the inner to the outer canthus of the lower eyelid (Fig. 4-1)

  • “Allergic shiners” refers to a darkened, violaceous, or tan coloring in the periorbital areas. Along with Dennie-Morgan folds, this coloring is an instant clue to atopy (the genetic tendency to develop allergic rhinitis, asthma, and atopic dermatitis) (Fig. 4-2)

Molluscum Contagiosum

Distinguishing Features

  • Dome-shaped, waxy or pearly papules with a central white core (umbilication) (Figs. 4-3 and 4-4)



Distinguishing Features

  • 1.0 to 2.0 mm in diameter, white or yellow cysts (Fig. 4-5)

  • Lesions in children spontaneously resolve over time

Stye (Hordeolum)

Distinguishing Features

  • Painful, warm, swollen, red papule on the eyelid margin (Fig. 4-6)

  • May cause blurring of vision

Meibomian Cyst (Chalazion)

Distinguishing Features

  • Nontender, firm papule located deep within the lid or the tarsal plate

  • Lid discomfort, redness, tenderness, swelling

  • Eversion of the eyelid may reveal the dilated meibomian gland (Fig. 4-7, A and B)

Periorificial (Periocular) Dermatitis

Jan 8, 2023 | Posted by in Dermatology | Comments Off on Eyelids and Periorbital Area

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