tag:blogger.com,1999:blog-9870114.post4000984027119536145..comments2024-03-10T08:41:32.400+00:00Comments on VIRTUAL GRAND ROUNDS IN DERMATOLOGY 2.0: Periocular Dermatitis in a ChildHumane Medicine Huihttp://www.blogger.com/profile/07113291188306363130noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-9870114.post-33539267767013863942012-02-28T02:12:42.980+00:002012-02-28T02:12:42.980+00:00from pediatric PA, Brian Maurer: "This could...from pediatric PA, Brian Maurer: "This could be a mild contact dermatitis, exacerbated by rubbing--but there doesn't seem to be a history of the hallmark of pruritis.<br />I've seen peri-ocular herpes present in this distribution. Admittedly, this photo was taken ten days out--any history of initial vessicular eruption or crusting? If so, it would be important to perform a fluorescein staining of the cornea to look for dendritic signs.<br />I also thought about a mild dacryostenosis/dacryocystitis, although again there is no history of ocular discharge. Interesting that the area of inflammation is more medial than lateral in the photograph.<br />If there is no ocular involvement, you could always treat with an oral antihistamine such as Benadryl or hydroxyzine and observe--somewhat less effective, but safer than topical steroid creams."Humane Medicine Huihttps://www.blogger.com/profile/07113291188306363130noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-10467520683507493282012-02-28T02:11:17.132+00:002012-02-28T02:11:17.132+00:00from Lili Mann (pediatric dermatology resident: &q...from Lili Mann (pediatric dermatology resident: "Interesting - looks like there might be some upper lid involvement too - hard to tell from the photo. If yes, I'd wonder about atopic dermatitis. I'd expect AD and allergic contact dermatitis to both be itchy though, which is odd. The periocular derm that I've seen is usually more discrete papules. Hmm. <br /> <br />We use HC 2.5% ointment around the eye BID x 2-3 days without worrying at all about ocular effects, so they could try that. Or tincture of time if it's not bothering the child."Humane Medicine Huihttps://www.blogger.com/profile/07113291188306363130noreply@blogger.comtag:blogger.com,1999:blog-9870114.post-55204079228589950412012-02-28T02:10:24.432+00:002012-02-28T02:10:24.432+00:00From Fran Storrs: "Sure looks like cont derm...From Fran Storrs: "Sure looks like cont derm to me. Bitsy vesicles. Could be on a parent and transfer to child or in a nose drop?? or on kids hands?? May soon be bilateral. Koh neg I assume. If those are pustules could even be candida."Humane Medicine Huihttps://www.blogger.com/profile/07113291188306363130noreply@blogger.com