Periocular Manifestation in Acute Atopic Dermatitis in a Paediatric Patient. A Case Report

Authors

  • Manuel Flores Sáenz Universidad de Alcalá, Departamento de Cirugía, Ciencias Médicas y Sociales, 28871, Alcalá de Henares, España https://orcid.org/0009-0001-1049-5102
  • Julia Rodríguez Redondo Facultativa Especialista de Área Pediatría en Centro de Salud Miguel de Cervantes. Alcalá de Henares.

DOI:

https://doi.org/10.37536/RIECS.2024.9.1.404

Keywords:

Dermatitis, Atopic, Eczema, Skin Diseases, Pruritus, Erythema, Epithelial barrier, SCORAD, Paediatrics

Abstract

Atopic dermatitis is a chronic skin condition characterized by itchy, scaly, and crusted lesions, most commonly affecting infants and children. The condition presents with intense pruritus and a chronic course with exacerbations. Periorbital involvement is expected due to the thin and sensitive skin in this area, and the inflammation can be exacerbated by rubbing or scratching. This case reports a 5-year-old girl with bilateral periorbital inflammation that had been present for 4 hours. She had a history of atopic dermatitis and no known surgical history or medication allergies but was allergic to shellfish. No medication or topical cream was administered for the described episode. Upon waking up, she presented with newly developed periorbital inflammation. She had not consumed any food to which she was known to be allergic, and there had been no increase in eyelid scratching. There was no recollection of contact with any toxic agents. During the physical examination, erythematous scaly plaques were observed on both cheeks, chin, and neck, and periorbital inflammation accompanied by eyelid and periorbital Dennie-Morgan fold. The primary diagnosis was periorbital atopic dermatitis in the context of an acute atopic dermatitis flare-up. The prescribed treatment included prednisolone acetate (Estilsona) for five days and pimecrolimus for the atopic dermatitis. Atopic dermatitis is a complex condition with a multifactorial aetiology, and its management can be challenging. Further research is needed to develop more effective treatments for atopic dermatitis.

References

Dermatitis atópica Mercedes Escarrer Jaume 1 M.a Teresa Guerra Pérez 2 Presidenta de SEICAP. Servicio de Alergia y | Course Hero [Internet]. [citado 4 de enero de 2024]. Disponible en: https://www.coursehero.com/file/85544120/11-dermatitis-atopicapdf/

Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis [Internet]. [citado 4 de enero de 2024]. Disponible en: https://medilib.ir/uptodate/show/1729

Wollenberg A, Christen-Zäch S, Taieb A, Paul C, Thyssen JP, de Bruin-Weller M, et al. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. diciembre de 2020;34(12):2717-44.

Management of severe atopic dermatitis (eczema) in children [Internet]. [citado 4 de enero de 2024]. Disponible en: https://medilib.ir/uptodate/show/1726

Silverberg JI, Hou A, Warshaw EM, DeKoven JG, Maibach HI, Belsito DV, et al. Prevalence and Trend of Allergen Sensitization in Adults and Children with Atopic Dermatitis Referred for Patch Testing, North American Contact Dermatitis Group Data, 2001-2016. J Allergy Clin Immunol Pract. julio de 2021;9(7):2853-2866.e14.

Odhiambo JA, Williams HC, Clayton TO, Robertson CF, Asher MI, ISAAC Phase Three Study Group. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol. diciembre de 2009;124(6):1251-1258.e23.

Mortz CG, Andersen KE, Dellgren C, Barington T, Bindslev-Jensen C. Atopic dermatitis from adolescence to adulthood in the TOACS cohort: prevalence, persistence and comorbidities. Allergy. julio de 2015;70(7):836-45.

Vinding GR, Zarchi K, Ibler KS, Miller IM, Ellervik C, Jemec GBE. Is adult atopic eczema more common than we think? - A population-based study in Danish adults. Acta Derm Venereol. julio de 2014;94(4):480-2.

Czarnowicki T, He H, Krueger JG, Guttman-Yassky E. Atopic dermatitis endotypes and implications for targeted therapeutics. J Allergy Clin Immunol. enero de 2019;143(1):1-11.

Ständer S. Atopic Dermatitis. N Engl J Med. 25 de marzo de 2021;384(12):1136-43.

Tsakok T, Woolf R, Smith CH, Weidinger S, Flohr C. Atopic dermatitis: the skin barrier and beyond. Br J Dermatol. marzo de 2019;180(3):464-74.

Published

31-05-2024

Issue

Section

Casos clínicos