{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:35:52Z","timestamp":1783020952290,"version":"3.54.6"},"reference-count":36,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Eyelid dermatitis is an inflammatory disease affecting the palpebral skin characterized by itching, edema, and scaling of the periorbital area. This entity can be a manifestation of various underlying dermatological diseases, but allergic contact dermatitis (ACD) is the predominant etiology of eyelid dermatitis among patients, being diagnosed in 43.4% of cases. The thin and highly permeable nature of eyelid skin increases its susceptibility to allergens, making it a distinct clinical entity. This study aimed to identify the primary haptens associated with eyelid ACD and compare these findings with the allergens implicated in non-eyelid ACD over a 25-year period in a large cohort of patients. Methods: We conducted a monocentric, retrospective study on a dataset of 7955 patients patch-tested for ACD at the Outpatient Allergy Dermatology Clinic of the Azienda Ospedaliera Universitaria Senese (AOUS) from 1997 to 2021. Eyelid ACD cases were identified based on clinical features and positive patch test results. Data on demographics, occupation, and personal history of atopy were collected. The statistical analyses assessed the associations between allergens and eyelid ACD. The trends in the sensitization rates for the most prevalent allergens were also evaluated. Results: Eyelid ACD was identified in 4.6% of the study population, predominantly affecting women (88.6%). Patients with eyelid ACD were more likely to exhibit single-hapten positivity (54.6%) and an atopic phenotype (52.3%) compared to non-eyelid ACD cases. Nickel sulfate (54%), cobalt chloride (13.4%), and thimerosal (12.6%) were the most common allergens associated with eyelid ACD. While thimerosal sensitization decreased significantly following its removal from topical products, nickel sensitization increased, likely due to exposure from electronic devices and hand\u2013eye contact. Conclusions: The haptens identified in eyelid ACD largely overlap with those found in other body regions, including metals, fragrances, and preservatives. However, the unique characteristics of eyelid skin and hand\u2013eye contact patterns play a significant role in sensitization. This study highlights the need for further investigation into the pathophysiology of eyelid allergic contact dermatitis, with particular emphasis on elucidating the mechanisms of hapten sensitization. Such insights could contribute to the development of effective strategies aimed at reducing allergen exposure.<\/jats:p>","DOI":"10.3390\/jcm14030823","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T07:54:08Z","timestamp":1738050848000},"page":"823","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Eyelid Contact Dermatitis: 25-Year Single-Center Retrospective Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8247-3666","authenticated-orcid":false,"given":"Giovanni","family":"Rubegni","sequence":"first","affiliation":[{"name":"Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2479-521X","authenticated-orcid":false,"given":"Tommaso","family":"Padula","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5238-2336","authenticated-orcid":false,"given":"Laura","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8315-3413","authenticated-orcid":false,"given":"Martina","family":"D\u2019Onghia","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-4310","authenticated-orcid":false,"given":"Linda","family":"Tognetti","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4009-0659","authenticated-orcid":false,"given":"Elisa","family":"Cinotti","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lazzeri","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Ermini","sequence":"additional","affiliation":[{"name":"F.I.R.M.A. S.p.A., Allergologia e Immunologia Clinica, 50100 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1818-6275","authenticated-orcid":false,"given":"Alessandra","family":"Cartocci","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gian Marco","family":"Tosi","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/j.1600-0536.1992.tb05242.x","article-title":"Eyelid Dermatitis: An Evaluation of 150 Patients","volume":"27","author":"Valsecchi","year":"1992","journal-title":"Contact Dermat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/j.1600-0536.1986.tb01321.x","article-title":"Eyelid Dermatitis: The R\u00f4le of Atopy and Contact Allergy","volume":"15","author":"Svensson","year":"1986","journal-title":"Contact Dermat."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/j.jaad.2020.07.020","article-title":"Eyelid Dermatitis in Patients Referred for Patch Testing: Retrospective Analysis of North American Contact Dermatitis Group Data, 1994\u20132016","volume":"84","author":"Warshaw","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/j.1600-0846.2007.00183.x","article-title":"Functional Analyses of the Eyelid Skin Constituting the Most Soft and Smooth Area on the Face: Contribution of Its Remarkably Large Superficial Corneocytes to Effective Water-Holding Capacity of the Stratum Corneum","volume":"13","author":"Pratchyapruit","year":"2007","journal-title":"Ski. Res. Technol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/S0190-9622(03)02112-1","article-title":"Quality of Life in Patients with Allergic Contact Dermatitis","volume":"49","author":"Kadyk","year":"2003","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.clae.2007.07.008","article-title":"Management of Chronic Habits of Abnormal Eye Rubbing","volume":"31","author":"McMonnies","year":"2008","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1097\/ICO.0b013e3181ca3668","article-title":"Meibomian Gland Duct Distortion in Patients with Perennial Allergic Conjunctivitis","volume":"29","author":"Arita","year":"2010","journal-title":"Cornea"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.mcna.2019.08.012","article-title":"Allergic Contact Dermatitis","volume":"104","author":"Nassau","year":"2020","journal-title":"Med. Clin. N. Am."},{"key":"ref_9","unstructured":"Fowler, J.F., and Zirwas, M.J. (2019). Fisher\u2019s Contact Dermatitis, Contact Dermatitis Institute. [7th ed.]."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S0190-9622(89)70165-1","article-title":"A Review of 79 Cases of Eyelid Dermatitis","volume":"21","author":"Nethercott","year":"1989","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1600-0536.2006.00927.x","article-title":"The Aetiology of Eyelid Dermatitis: A 10-Year Retrospective Analysis","volume":"55","author":"Amin","year":"2006","journal-title":"Contact Dermat."},{"key":"ref_12","first-page":"291","article-title":"Eyelid Dermatitis: An Evaluation of 232 Patch Test Patients over 5 Years","volume":"42","author":"Cooper","year":"2000","journal-title":"Contact Dermat."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1600-0536.1996.tb02148.x","article-title":"Facial Dermatitis and Eyelid Dermatitis: A Comparison of Patch Test Results and Final Diagnoses","volume":"34","author":"Shah","year":"1996","journal-title":"Contact Dermat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.ajo.2010.03.026","article-title":"Periorbital Contact Sensitization","volume":"150","author":"Landeck","year":"2010","journal-title":"Am. J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/j.0105-1873.2004.00311.x","article-title":"Eyelid Dermatitis: A Report of 215 Patients","volume":"50","author":"Guin","year":"2004","journal-title":"Contact Dermat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/01634989-200306000-00004","article-title":"Eyelid Dermatitis: An Evaluation of 447 Patients","volume":"14","author":"Ayala","year":"2003","journal-title":"Am. J. Contact Dermat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/cod.14507","article-title":"Contact Allergy to SIDAPA Baseline Series Allergens in Patients with Eyelid Dermatitis: An Italian Multicentre Study","volume":"90","author":"Stingeni","year":"2024","journal-title":"Contact Dermat."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/cod.12157","article-title":"Periorbital Dermatitis in 4779 Patients\u2013Patch Test Results during a 10-Year Period","volume":"70","author":"Landeck","year":"2014","journal-title":"Contact Dermat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"78","DOI":"10.2310\/6620.2007.06041","article-title":"Common Contact Allergens Associated with Eyelid Dermatitis: Data from the North American Contact Dermatitis Group 2003\u20132004 Study Period","volume":"18","author":"Rietschel","year":"2007","journal-title":"Dermatitis"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/j.1365-2133.2006.07319.x","article-title":"Percutaneous Penetration of Sodium Lauryl Sulphate Is Increased in Uninvolved Skin of Patients with Atopic Dermatitis Compared with Control Subjects","volume":"155","author":"Jakasa","year":"2006","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/bjd.15065","article-title":"Skin Absorption through Atopic Dermatitis Skin: A Systematic Review","volume":"177","author":"Kezic","year":"2017","journal-title":"Br. J. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1016\/j.jaci.2014.06.014","article-title":"Causes of Epidermal Filaggrin Reduction and Their Role in the Pathogenesis of Atopic Dermatitis","volume":"134","author":"Thyssen","year":"2014","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/j.1600-0536.1989.tb03179.x","article-title":"Allergic Contact Dermatitis from Nickel in Eyeshadow","volume":"20","author":"Goh","year":"1989","journal-title":"Contact Dermat."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"445","DOI":"10.2340\/0001555571445447","article-title":"Colophony in Mascara as a Cause of Eyelid Dermatitis. Chemical analyses and patch testing","volume":"71","author":"Karlberg","year":"1991","journal-title":"Acta Derm. Venereol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zemba, C., Romaguera, C., and Vilaplana, J. (1992). Allergic Contact Dermatitis from Nickel in an Eye Pencil. Contact Dermat., 27.","DOI":"10.1111\/j.1600-0536.1992.tb05224.x"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/j.1468-3083.2008.02949.x","article-title":"Periocular Dermatitis: A Report of 401 Patients","volume":"23","author":"Sas","year":"2009","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1067\/mjd.2002.122736","article-title":"Eyelid Dermatitis: Experience in 203 Cases","volume":"47","author":"Guin","year":"2002","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/j.0105-1873.2004.00334.x","article-title":"Allergic and Non-Allergic Periorbital Dermatitis: Patch Test Results of the Information Network of the Departments of Dermatology during a 5-Year Period","volume":"51","author":"Herbst","year":"2004","journal-title":"Contact Dermat."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Katta, R. (2008). Common Misconceptions in Contact Dermatitis Counseling. Dermatol. Online J., 14.","DOI":"10.5070\/D39RF739T3"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/ACI.0b013e3283306990","article-title":"Allergy to Ophthalmic Preservatives","volume":"9","author":"Hong","year":"2009","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1080\/10937400701389875","article-title":"A Review of Thimerosal (Merthiolate) and Its Ethylmercury Breakdown Product: Specific Historical Considerations Regarding Safety and Effectiveness","volume":"10","author":"Geier","year":"2007","journal-title":"J. Toxicol. Environ. Health B Crit. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1590\/abd1806-4841.20153992","article-title":"Contact Dermatitis to Methylisothiazolinone","volume":"90","author":"Scherrer","year":"2015","journal-title":"An. Bras. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"70S","DOI":"10.1177\/1091581819838792","article-title":"Amended Safety Assessment of Methylisothiazolinone as Used in Cosmetics","volume":"38","author":"Burnett","year":"2019","journal-title":"Int. J. Toxicol."},{"key":"ref_34","first-page":"5S","article-title":"Amended Safety Assessment of Methylisothiazolinone as Used in Cosmetics","volume":"40","author":"Burnett","year":"2021","journal-title":"Int. J. Toxicol."},{"key":"ref_35","first-page":"83","article-title":"Contact Allergy Caused by Fragrance Mix and Myroxylon Pereirae (Balsam of Peru)\u2014A Retrospective Study","volume":"35","year":"2011","journal-title":"Coll. Antropol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/s41433-021-01668-x","article-title":"Ocular Benzalkonium Chloride Exposure: Problems and Solutions","volume":"36","author":"Goldstein","year":"2022","journal-title":"Eye"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/823\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:53Z","timestamp":1759919813000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/823"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030823"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030823","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]}}}