Relevant allergens by periorbital allergic contact dermatitis. Oxybuprocain, an underestimated allergen?

Abstract

Background. Periorbital allergic contact dermatitis is a rare disease and the main differential diagnoses are atopic and seborrhoeic dermatitis. The diagnosis is based on clinical appearance, patient history and patch testing. Current systematic overviews on contact allergens involved are lacking and with changes in medical preparations, new relevant antigens may emerge. Patients and methods. Based on the systematic data of the information network of dermatological clinics (IVDK), patch test reactions in 48,969 patients tested between 1996 and 2000 were evaluated. A total of 763 patients suffered from periorbital dermatitis which was suspected to be due to the use of topical medication. Results. The most common epidermal sensitizations in the general population were observed against nickel and fragrances. In the periorbital dermatitis group, sensitization against local anaesthetics; and antibiotics was more frequent than in the general population. Conclusions. In three patients, oxybuprocain was identified as the causative agent, which has not yet been recognized as a common allergen.