Wednesday, May 06, 2015

Unusual Eyelid Dermatitis

The patient is a 23 y.o. man with a 3 month history of an eyelid dermatitis.  He was treated with a topical corticosteroid and a topical antifunal.  Neither was effective.  Personal history is significant for Crohn’s disease (in remission for years with 6-mercaptopurine).  His father has rosacea.

O/E:  There are erythematous, slightly scaly papules at the left outer canthus and lower lid.  The lower lid margin is slightly red.  Right eye completely normal.


3 mm punch biopsy obtained.

Eyelid Dermatotis:  Consider granulomatous rosacea, demodeciasis.  Cutaneous Crohn’s disease (unlikely)

Follow-up:  Biopsy is c/w rosacea.  No demodex noted.  No granulomatous changes.

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