Ayala Fabio, Fabbrocini Gabriella, Bacchilega Roberto, Berardesca Enzo, Caraffini Stefano, Corazza Monica, Flori Maria Laura, Francalanci Stefano, Guarrera Marcella, Lisi Paolo, Santucci Baldassarre, Schena Donatella, Suppa Francesco, Valsecchi Rossano, Vincenzi Colombina, Balato Nicola
Dipartmento di Dermatologia, Università di Napoli Federico II, Naples, Italy.
Am J Contact Dermat. 2003 Jun;14(2):69-74.
Eyelids can be affected by various types of dermatitis that are often difficult to diagnose.
The aim of the study was to establish some guidelines for a correct diagnosis.
A total of 447 patients treated at 12 research units for eczema or other inflammatory dermatitis located on the eyelids were invited to complete a questionnaire. When necessary, patch tests with haptens of the standard series from Gruppo Italiano di Ricerca sulle Dermatiti da Contatto e Ambientali della Società Italiana di Dermatologia e Venereologia (SIDEV-GIRDCA) were performed.
Of the subjects studied, 50.2 % were diagnosed with allergic contact dermatitis (ACD); 20.9% were affected by irritant contact dermatitis (ICD), 13.5% by atopic dermatitis, 6.3% by seborrheic dermatitis, 6.5% by aspecific xerotic dermatitis, and 2.3% by psoriasis. Approximately 91% of all subjects reported an absence of familial atopy. A significant statistical association between diagnosis type and a personal history of atopy was evident (p <.000001, chi-square test). The results of gradual logistic regression models showed four-eyelid involvement as the main risk factor for ACD (odds ratio [OR] = 3.0; 95% CI, 1.1-8.1); with ICD, the main risk factor was the onset of symptoms at between 2 and 6 months (OR = 2.1; 95% CI, 1.1-4.0), whereas for atopic dermatitis, the main risk factors were the onset of symptoms later than 6 months and a personal history of atopy (OR = 4.9 and 3.6, respectively).
Results suggest that many characteristics of the patients examined can be used for the differential diagnosis of palpebral eczematous dermatitis.
眼睑可受多种类型的皮炎影响，这些皮炎往往难以诊断。
本研究的目的是建立一些正确诊断的指导原则。
邀请在12个研究单位接受治疗的447例眼睑湿疹或其他炎症性皮肤病患者填写问卷。必要时，使用意大利皮肤病学和性病学学会环境接触性皮炎研究组（SIDEV - GIRDCA）标准系列的半抗原进行斑贴试验。
在所研究的受试者中，50.2%被诊断为过敏性接触性皮炎（ACD）；20.9%受刺激性接触性皮炎（ICD）影响，13.5%受特应性皮炎影响，6.3%受脂溢性皮炎影响，6.5%受非特异性干性性皮炎影响，2.3%受银屑病影响。约91%的所有受试者报告无家族性特应性。诊断类型与特应性个人史之间存在显著的统计学关联（p <.000001，卡方检验）。逐步逻辑回归模型的结果显示，双眼睑受累是ACD的主要危险因素（比值比[OR] = 3.0；95%置信区间[CI]，1.1 - 8.1）；对于ICD，主要危险因素是症状在2至6个月之间出现（OR = 2.1；95% CI，1.1 - 4.0），而对于特应性皮炎，主要危险因素是症状在6个月后出现和特应性个人史（分别为OR = 4.9和3.6）。
结果表明，所检查患者的许多特征可用于睑部湿疹性皮炎的鉴别诊断。
