Eyelid Dermatitis in a Teenager: Case Study and Management Approach
by: Ashlee Baldree
At Village Dermatology in Katy and Houston, Texas, we care for patients of all ages presenting with rashes, skin lesions, and facial irritation. This case highlights an 18-year-old female with a persistent rash on the face, emphasizing the importance of accurate diagnosis and tailored treatment for eyelid dermatitis.
Patient Presentation
An 18-year-old female presented as a new patient with enlarging skin lesions on the left cheek, nose, and right cheek. The lesions had been present for several months, were moderate in severity, and had not been treated previously. She reported that the rash frequently recurred around her eyes.
Dermatologic Examination
A full exam of the scalp, face, ears, lips, and forearms was performed using a dermatoscope. Findings included:
Facial Dermatitis (Unspecified): Patches of lighter, irritated skin around the eyes.
The clinical appearance raised consideration of atopic dermatitis, seborrheic dermatitis, allergic contact dermatitis (ACD), or lupus.
No systemic symptoms were reported.
Assessment and Plan
The differential diagnosis included several causes of eyelid dermatitis. Since no definitive diagnosis could be made during the initial visit, treatment was focused on symptomatic relief and careful follow-up.
Treatment Initiated
Tacrolimus 0.1% ointment: Apply twice daily to affected areas.
Ketoconazole 2% cream: Apply twice daily for two weeks.
Emollients were recommended to maintain hydration and support skin barrier function.
Counseling and Education
The patient was counseled regarding:
The chronic and sometimes unclear nature of eyelid dermatitis.
Avoiding potential irritants and allergens around the eyes (makeup, harsh cleansers, fragranced products).
Monitoring for warning signs such as fever, worsening rash, or new systemic symptoms.
Follow-Up
The patient was scheduled for follow-up in 4 weeks. If symptoms persist, patch testing will be considered to identify possible allergens. Blood work for ANA (antinuclear antibodies) was also ordered to rule out autoimmune causes such as lupus.
Key Takeaway
Eyelid dermatitis in young patients can have multiple potential causes. Early dermatology evaluation, gentle treatment, and close follow-up are essential to achieve relief and prevent long-term complications.
At Village Dermatology in Katy and Houston, TX, we provide expert evaluation and customized treatment plans for patients with rashes, dermatitis, and facial skin conditions.
