{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:26:45Z","timestamp":1786728405977,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Refractory periorbital dermatitis has a chronic course with exacerbations leading to discomfort and cosmetic issues, yet characterization of treatment options is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>The objective was to present comprehensive demographic data and medical management of a series of patients with refractory periorbital dermatitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and Design:<\/jats:title>\n                    <jats:p>Retrospective review identified patients treated at a single institution from January 2010 to August 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Descriptive analyses were performed. Demographic data and treatment history were reviewed and data including medication, use, date of use and discontinued use, reason for discontinuation (if applicable), refractory status, formulation, concentration, and dose frequency were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Analysis Used:<\/jats:title>\n                    <jats:p>Descriptive analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-five patients were included. The average age at first diagnosis was 60.3 years (sd 14.9). 82.2% were women and 84.4% identified as Caucasian. Triamcinolone cream was most frequently used followed by tobramycin\u2013dexamethasone, tacrolimus, and neomycin\u2013polymyxin\u2013dexamethasone. Less than 30% of patients on triamcinolone were refractory. 13.3% of patients used topical hydrocortisone, with over 80% of these patients experiencing refractory episodes of persistent irritation and erythema. Most patients were refractory during initial use or the first recurrence of periorbital dermatitis flare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>By better characterizing the diverse treatment regimens in a unique subset of refractory patients, we hope to better inform potential courses of medical management for periorbital dermatitis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2944_22","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T12:14:28Z","timestamp":1695298468000},"page":"3386-3393","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["The treatment of refractory periorbital dermatitis"],"prefix":"10.4103","volume":"71","author":[{"given":"Elana A","family":"Meer","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University of San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suraj B","family":"Patel","sequence":"additional","affiliation":[{"name":"Lincoln Memorial University - DeBusk College of Osteopathic Medicine, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William B A","family":"Herskowitz","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar A","family":"Brice\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"R1-20251009","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1111\/j.1365-2133.2008.08790.x","article-title":"Periorbital dermatitis-a recalcitrant disease: Causes and differential diagnoses","volume":"159","author":"Feser","year":"2008","journal-title":"Br J Dermatol"},{"key":"R2-20251009","doi-asserted-by":"crossref","DOI":"10.3389\/fcimb.2022.861053","article-title":"Global burden, incidence and disability-adjusted life-years for dermatitis: A systematic analysis combined with socioeconomic development status, 1990\u20132019","volume":"12","author":"Xue","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"R3-20251009","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1038\/sj.eye.6702367","article-title":"Tacrolimus ointment vs steroid ointment for eyelid dermatitis in patients with atopic keratoconjunctivitis","volume":"21","author":"Nivenius","year":"2007","journal-title":"Eye"},{"key":"R4-20251009","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":"R5-20251009","first-page":"159","article-title":"Periorbital dermatitis: Causes, differential diagnoses and therapy","volume":"8","author":"Feser","year":"2010","journal-title":"JDDG - J Ger Soc Dermatol"},{"key":"R7-20251009","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jaad.2014.03.023","article-title":"Guidelines of care for the management of atopic dermatitis: Section 2. Management and treatment of atopic dermatitis with topical therapies","volume":"71","author":"Eichenfield","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"R8-20251009","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1159\/000051700","article-title":"Safe and effective treatment of refractory facial lesions in atopic","volume":"203","author":"Kawakami","year":"2001","journal-title":"Dermatology"},{"key":"R9-20251009","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1080\/09546630310004324","article-title":"Safe treatment of head\/neck AD with tacrolimus ointment","volume":"14","author":"Kang","year":"2003","journal-title":"J Dermatol Treat"},{"key":"R10-20251009","first-page":"267","article-title":"Tacrolimus ointment in the treatment of eyelid dermatitis","volume":"73","author":"Freeman","year":"2004","journal-title":"Cutis"},{"key":"R11-20251009","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1111\/j.1468-3083.2008.03056.x","article-title":"Tacrolimus ointment 0.1% in the treatment of allergic contact eyelid dermatitis","volume":"23","author":"Katsarou","year":"2009","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R12-20251009","doi-asserted-by":"crossref","first-page":"P37","DOI":"10.1016\/j.jaad.2003.10.149","article-title":"Peri-orbital dermatitis-a variant of peri-oral dermatitis","volume":"50","author":"Fiona","year":"2004","journal-title":"J Am Acad Dermatol"},{"key":"R13-20251009","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/S0190-9622(86)70218-1","article-title":"Periocular dermatitis akin to the perioral variety","volume":"15","author":"Fisher","year":"1986","journal-title":"J Am Acad Dermatol"},{"key":"R14-20251009","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1080\/00015550510040040","article-title":"Pimecrolimus cream 1% is effective in seborrhoeic dermatitis refractory to treatment with topical corticosteroids","volume":"86","author":"Cunha","year":"2005","journal-title":"Acta Derm Venereol"},{"key":"R15-20251009","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/0190-9622(91)70038-4","article-title":"Topical metronidazole in the treatment of perioral dermatitis","volume":"24","author":"Veien","year":"1991","journal-title":"J Am Acad Dermatol"},{"key":"R16-20251009","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD005500.pub2","article-title":"Topical pimecrolimus for eczema","author":"Ashcroft","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"R17-20251009","article-title":"Successful treatment of severe atopic dermatitis with calcitriol and paricalcitol in an 8-year-old girl","volume":"2018","author":"Bothou","year":"2018","journal-title":"Case Rep Pediatr"},{"key":"R18-20251009","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jdcr.2018.09.012","article-title":"Topically applied low-dose calcitriol ameliorates atopic eyelid dermatitis","volume":"5","author":"Tukaj","year":"2019","journal-title":"JAAD Case Rep"},{"key":"R19-20251009","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":"R20-20251009","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 Dermatitis"},{"key":"R21-20251009","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1159\/000245712","article-title":"Contact allergy in patients with periorbital eczema: An analysis of allergens","volume":"195","author":"Ockenfels","year":"1997","journal-title":"Dermatology"},{"key":"R22-20251009","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 Dermatitis"},{"key":"R23-20251009","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1080\/09546630410033781","article-title":"Long-term safety and tolerability of pimecrolimus cream 1% and topical corticosteroids in adults with moderate to severe atopic dermatitis","volume":"15","author":"Luger","year":"2004","journal-title":"J Dermatolog Treat"},{"key":"R24-20251009","article-title":"Triamcinolone","author":"Sidhu","year":"2021","journal-title":"StatPearls"},{"key":"R25-20251009","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/ajd.12292","article-title":"Ocular side-effects of topical corticosteroids: What a dermatologist needs to know","volume":"56","author":"Daniel","year":"2015","journal-title":"Aust J Dermatol"},{"key":"R26-20251009","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1038\/eye.1993.152","article-title":"Extensive visual loss with topical facial steroids","volume":"7","author":"Aggarwal","year":"1993","journal-title":"Eye"},{"key":"R27-20251009","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/j.1442-9071.2004.00787.x","article-title":"Clinical case notes. Glaucoma from topical corticosteroids to the eyelids","volume":"32","author":"Garrott","year":"2004","journal-title":"Clin Exp Ophthalmol"},{"key":"R28-20251009","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1001\/archderm.1978.01640180085023","article-title":"Glaucoma induced by application of corticosteroids to the periorbital region","volume":"114","author":"Nielsen","year":"1978","journal-title":"Arch Dermatol"},{"key":"R29-20251009","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0190-9622(81)70040-9","article-title":"Complications of topical hydrocortisone","volume":"4","author":"Guin","year":"1981","journal-title":"J Am Acad Dermatol"},{"key":"R30-20251009","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/j.1442-9071.2004.00787.x","article-title":"Glaucoma from topical corticosteroids to the eyelids","volume":"32","author":"Garrott","year":"2004","journal-title":"Clin Exp Ophthalmol"},{"key":"R31-20251009","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1111\/j.1365-2133.2007.08192.x","article-title":"A randomized controlled trial of pimecrolimus cream 1% in adolescents and adults with head and neck atopic dermatitis and intolerant of, or dependent on, topical corticosteroids","volume":"157","author":"Murrell","year":"2007","journal-title":"Br J Dermatol"},{"key":"R32-20251009","article-title":"Periocular triamcinolone use and intraocularpressures in a single-center, retrospective cohort","author":"Kim","year":"2022","journal-title":"J Ophthalmic Vis Res. Published online"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2944_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:26:37Z","timestamp":1786724797000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2944_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":31,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2944_22","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]},"assertion":[{"value":"2022-11-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-14","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}