Equis ISSN 2398-2977

Eyelid: blepharitis - allergic

Contributor(s): Paul E Miller, Graham Munroe

Introduction

  • Immune-mediated dermatosis particularly affecting the eyelids.
  • Cause: many possible allergens, eg pollen, mold, bedding, feedstuffs etc.
  • Signs: acute cases characterized by sudden onset edema and hyperemia of lids with pruritus; chronic cases have thickening and fibrosis of the lids and loss of hair.
  • Diagnosis: history, signs, allergen testing.
  • Treatment: relies heavily on identifying allerg en and removing it; locally applied or systemic anti-inflammatory drugs can be helpful.
  • Prognosis: acute cases - guarded; chronic cases - poor.

Pathogenesis

Etiology

  • Many possible allergens making specific cause identification difficult, eg:
    • Pollen and moulds.
    • Bedding and feedstuffs.
    • Chemicals, especially sprays, eg fly repellants, shampoos and drugs (topical and systemic).
    • Environmental contamination with cleaning chemicals in stables or boxes, paints and preservatives, wood chips or tack cleaning chemicals.

Pathophysiology

  • Blepharitis can occur with a number of immune-mediated dermatoses.
  • Acute allergic reactions are characterized by edema and hyperemia of the lids and subsequent pruritus.
  • Chronic reactions lead to thickening and fibrosis of the lids and alopecia.

Timecourse

  • Acute reactions can occur in minutes whilst chronic changes may occur over weeks, months or years.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers


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